Sample records for bronchopneumonia

  1. Poorly Treated Broncho-Pneumonia with Progression to Empyema Thoracis in Nigerian Children

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    Eyo Effiong Ekpe


    Full Text Available AIM: Poorly treated bronchopneumonia is the most common cause of empyema thoracis in Nigeria. Ignorance poverty and quackery are the major reasons for inadequate treatment. METHOD: All paediatric patients diagnosed and treated for empyema thoracis secondary to poorly treated bronchopneumonia in our hospital between November 2006 and January 2009 had their case notes retrieved, and data collated into individual proforma for analysis. RESULTS: During the 26 months period, there were 2106 admissions into children emergency unit of our hospital, with 267 having bronchopneumonia (12% and 18 having empyema thoracis (6.7% case prevalence. The age range was 1 month to 16 years with mean of 6.4 years and male: female ratio 3.5: 1. The right pleural space was affected in 50%, left pleural space in 33.33%, and both pleural spaces in 16.66%. Up to 61% of mothers of the patients with empyema thoracis had no or only primary level of formal education, 77.78% of such mothers were not gainfully employed and 44.43% of patients were previously treated by medical charlatans before presentation in our hospital. All patients were successfully treated with antibiotic and tube thoracostomy drainage with satisfactory recovery. CONCLUSION: Empyema thoracis 20 poorly treated bronchopneumonia is still prevalent in Nigeria. Mass literacy campaign, poverty alleviation and provision of affordable and easily accessible medical care throughout the whole country are the immediate solution to this menace. [TAF Prev Med Bull 2010; 9(3.000: 181-186

  2. Pneumomediastinum and subcutaneous emphysema in a cat associated with necrotizing bronchopneumonia caused by feline herpesvirus-1. (United States)

    Maes, Sofie; Van Goethem, Bart; Saunders, Jimmy; Binst, Dominique; Chiers, Koen; Ducatelle, Richard


    This report describes a 1-year-old cat with acute dyspnea. Thoracic radiography revealed a pneumomediastinum and severe subcutaneous emphysema. Lower airway surgical exploration was unable to determine the cause. At postmortem examination, acute necrotizing bronchopneumonia and fibrinonecrotic tracheitis due to feline herpesvirus-1 were diagnosed.

  3. Active Immunization with Lipopolysaccharide Pseudomonas Antigen for Chronic Pseudomonas Bronchopneumonia in Guinea Pigs


    Pennington, James E.; Hickey, William F.; Blackwood, Linda L.; Arnaut, M. Amin


    Chronic respiratory infection with Pseudomonas aeruginosa is a leading clinical problem among patients with cystic fibrosis. Because antimicrobial agents are usually ineffective in eradicating these infections, additional therapeutic or prophylactic measures should be considered. In this study, an experimental guinea pig model of chronic Pseudomonas aeruginosa bronchopneumonia was utilized to determine whether active immunization with lipopolysaccharide (LPS) P. aeruginosa antigen may favorab...

  4. Partial resolution of hypoplastic trachea in six english bulldog puppies with bronchopneumonia. (United States)

    Clarke, Dana L; Holt, David E; King, Lesley G


    Six English bulldog and nine nonbrachycephalic puppies with bronchopneumonia and radiographs were evaluated. Relative size of the trachea was measured by the tracheal diameter (TD) and the thoracic inlet distance (TI), expressed as a ratio (TD:TI). At diagnosis of bronchopneumonia, there was a significant difference between the median TD:TI of the bulldog puppies (0.07; range, 0.06-0.09) and that of the nonbrachycephalic puppies (0.14; range, 0.11-0.25; P=0.0004). At the same time, there was also a significant difference between the mean TD:TI of bulldog puppies (0.07±0.01) and that of nonbrachycephalic puppies (0.15±0.05; P=0.002). Follow-up radiographs showed significant increases in TD:TI ratio in all six bulldogs (median TD:TI = 0.14; range, 0.12-0.18; P=0.03 and mean TD:TI = 0.15±0.02; P=0.0007), whereas the ratio did not change significantly in the nonbrachycephalic control group (median TD:TI = 0.17; range, 0.14-0.22; P=0.10 and mean TD:TI = 0.18±0.03; P=0.06). Tracheal hypoplasia in some brachycephalic dogs might partially or completely resolve with growth to mature body size.

  5. Hartmannella vermiformis isolated from the cerebrospinal fluid of a young male patient with meningoencephalitis and bronchopneumonia. (United States)

    Centeno, M; Rivera, F; Cerva, L; Tsutsumi, V; Gallegos, E; Calderón, A; Ortiz, R; Bonilla, P; Ramírez, E; Suárez, G


    Meningoencephalitis and bronchopneumonia were documented in a patient from Peubla, Mexico. The patient began with symptoms and signs of a common flu and 12 days after the onset of his disease he was admitted to the hospital presenting symptoms and signs of meningoencephalitis. The clinical course evolved into an endocraneal hypertension syndrome with bronchopneumonia, coma and death. Wide-spectrum antibiotics, immunosuppressive and anti-tuberculosis therapy were unsuccessfully administered. Important antecedents were degree I malnutrition and repeated contact with polluted water. Post-mortem autopsy was not performed. Gram-positive cocci were isolated from the spinal fluid 2 days after admission, and then active amebae were isolated from three different samples of the spinal fluid at days 16, 18 and 19 after admission. Such samples were concentrated and inoculated onto specific culture media. Identification of amebae was based on their morphology and biochemistry. All amebae were Hartmannella vermiformis. Amebae were apparently not the cause of the disease and might be considered as an opportunistic colonizer which may have caused the evolution of the disease to become worse.

  6. Effect of aerosol inhalation of ipratropium bromide combined with budesonide and terbutaline on cytokines in children with bronchopneumonia

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    Xiang-Yu Che


    Full Text Available Objective: To explore the clinical efficacy of aerosol inhalation of ipratropium bromide combined with budesonide and terbutaline in the treatment of bronchopneumonia in children and the effect on cytokines. Methods: A total of 70 children with bronchopneumonia who were admitted in our hospital from March, 2015 to March, 2016 were included in the study and randomized into the study group and the control group. The patients in the control group were given anti-infection, oxygen inhalation, cough and asthma relieving, acidosis correcting, mask+oxygen driven aerosol inhalation of budesonide (0.5 mg/time and terbutaline (1.0 mg/time, with an oxygen flow rate of 5-7 L/min, 5-10 min every time, twice a day. On the above basis, the patients in the study group were given additional ipratropium bromide (1.0 mg/time. After 7-day treatment, the efficacy was evaluated. The levels of IL-6, TNF-毩, CRP, and WBC before and after treatment were detected. PEF, FVC, and FEV1 before and after treatment were detected. The improvement of clinical symptoms and signs, and the occurrence of adverse reactions were observed. Results: The levels of IL-6, TNF-毩, CRP, and WBC counting after treatment in the two groups were significantly reduced when compared with before treatment (P0.05. Conclusions: Ipratropium bromide combined with budesonide and terbutaline in the treatment of bronchopneumonia in children can rapidly relieve the symptoms, and improve the cytokine level, without obvious adverse reactions; therefore, it deserves to be widely recommended in the clinic.

  7. Comparative investigation on the efficacy of tulathromycin and florfenicol in the treatment of bronchopneumonia in feedlot calves

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    Jezdimirović Milanka


    Full Text Available The clinical efficacy of tulathromycin (TU and florfenicol (FL in the treatment of bronchopneumonia (BP caused by Pasteurella multocida which was isolated from nose swabs of diseased calves has been examined. The symptoms of bronchopneumonia (BP were quantified by means of the clinical score (CS with a maximum of 47 points. In the current investigation the average CS in diseased calves was 23.5± 0.15. The clinical efficacy of TU and FL was assessed every day in the first week after the administration of the drugs and was based on the decrease in CS and on microbiological findings on days 7, 28 and 35 after the completion of therapy. Tulathromycin was administered s.c., in the prescribed therapeutic dose (2.5 mg/kg BW, and florfenicol s.c., twice at a 48 h interval, in its respective therapeutic dose (40 mg/kg BW. In spite of the repeated administration of FL, TU was significantly more rapid to decrease the major clinical symptoms in the first four days following the application, in comparison with FL (P<0.05. On the fourth day after the administration, the clinical efficacy of TU in the therapy of BP in calves was 43.4±1.5 %, and of florfenicol 27.2±1.6 %. However, five days after the application of TU and two days after the repeated application of FL the assessed clinical efficacy of the two antibiotics was roughly the same. The average efficacy of TU was 57.1±0.0%, and of florfenicol 58.5±0.0%, both the individual and mean CS in the treated calves was 10 points, due to hyperthermia, which remained the only symptom. Six days after the administration of TU and three days after the repeated application of FL both antibiotics had equal maximum efficacy (100% in the treatment of BP. The clinical efficacy remained unchanged on day seven. The recovery was confirmed by the absence of P. multocida in nose swabs sampled on the seventh day after the initial treatment. However, in 4 calves (21.05 % of the 19 treated Streptococcus alpha haemolyticus


    Directory of Open Access Journals (Sweden)

    Daniel Pessoa Gomes da Silva


    Full Text Available Com o propósito de avaliar a segurança, a eficácia diagnóstica da biópsia pulmonar e comparar a possível ocorrência de complicações decorrentes da técnica, entre bezerros sadios e com broncopneumonia induzida, utilizaram-se dez bezerros (G1 sadios e vinte bezerros portadores de broncopneumonia, divididos em quatro grupos de cinco bezerros (G2 a G5, os quais foram biopsiados 12, 24, 48 e 72 horas após a inoculação com Mannheimia haemolytica, respectivamente. A presença de crepitação grossa, som submaciço à percussão e as alterações radiográficas auxiliaram no diagnóstico da broncopneumonia e localizaram a área pulmonar a ser biopsiada nos grupos G2 a G5. As alterações microscópicas, visualizadas nos animais do grupo G2 a G5, foram as de broncopneumonia fibrinopurulenta. Nos bezerros do grupo G1 as alterações relacionadas à técnica foram: tosse, epistaxe, dispneia mista, taquipneia e taquicardia. Cinco (25% bezerros com broncopneumonia desenvolveram hemotórax após a biópsia e as alterações relacionadas à técnica foram: taquipneia, taquicardia, tosse, dispneia mista, apatia, mucosas pálidas e decúbito. Conclui-se que a biópsia pulmonar permite o diagnóstico de broncopneumonia em bezerros, contudo as complicações decorrentes da técnica limitam o seu uso apenas nas situações em que os métodos convencionais não tenham possibilitado o diagnóstico.

    PALAVRAS-CHAVES: Bezerros, biópsia pulmonar, broncopneumonia, Mannheimia haemolytica.

    The purpose of this study was to evaluate the safety and diagnostic efficacy of lung biopsy and to compare the possible occurrence of complications due to this technique in healthy calves and in calves with bronchopneumonia. Thirty Holstein calves were divided into a group of ten healthy animals (G1 and into four experimental groups (G2 to G5 of five calves each

  9. 101 an epidemic of adenovirus type·' bronchopneumonia in bantu

    African Journals Online (AJOL)


    Jan 30, 1971 ... distinct whoop heard, although 11% had paroxysms of coughing ending in vomiting, and some of the white cell counts were very high. Temperatures were high, often for a week and more. The acute illness was long and many of the survivors came back with recurrences of pneumonia. This finding, together ...

  10. Evaluación clínica temprana del tratamiento de neumonías y bronconeumonías en Terapia Intensiva Cardiovascular / Early clinical assessment of pneumonia and bronchopneumonia treatment in a Cardiovascular Intensive Care Unit

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    Andrés M. Rodríguez Acosta


    Full Text Available Introducción: Las infecciones nosocomiales son frecuentes. La neumonía nosocomial es la segunda más común entre este tipo de infecciones y es la primera en la Unidad de Terapia Intensiva, donde alcanza una incidencia de 10 a 20 %.Objetivo: Determinar el efecto de la evaluación clínica evolutiva desde 48 - 72 horas de iniciado el tratamiento antimicrobiano.Método: Se realizó una investigación descriptiva, prospectiva de corte longitudinal, en 57 pacientes (muestreo incidental con diagnóstico de cardiopatía isquémica dolo-rosa, que desarrollaron neumonía o bronconeumonía nosocomial e ingresaron en la Unidad de Terapia Intensiva Cardiovascular del hospital “Dr. Celestino Hernández Ro-bau”, desde el 3 de enero al 31 de diciembre de 2013.Resultados: La categorización clínica inicial favoreció el diagnóstico de 50 neumonías y bronconeumonías precoces y 7 graves. La evaluación evolutiva desde las 48 - 72 ho-ras identificó la evolución no satisfactoria en 6 (12 % de las neumonías nosocomiales precoces y en 4 (57,1 % de las graves.Conclusiones: La evaluación clínica evolutiva temprana es útil para detectar la res-puesta al tratamiento antimicrobiano de las neumonías nosocomiales y actuar en consecuencia.

  11. CASE REPORT Neutropenic enterocolitis com- plicating acute ...

    African Journals Online (AJOL)


    Blood cultures, on admission, were negative. Bone marrow aspirate and trephine biopsy confirmed the diagnosis of acute lymphoblastic leukaemia. On immunophe- notyping, the ... with bronchopneumonia. Blood cultures confirmed septicaemia ..... registration by the New Zealand Medical Radiation. Technologists Board.

  12. South African Medical Journal - Vol 45, No 7 (1971)

    African Journals Online (AJOL)

    A Comparison Between Doxycycline and Ampicillin in the treatment of Bronchopneumonia complicating measles · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. I.R. Lang, 723-724 ...

  13. Pneumonia - children - community acquired (United States)

    Bronchopneumonia - children; Community-acquired pneumonia - children; CAP - children ... Viruses are the most common cause of pneumonia in infants and children. Ways your child can get CAP include: Bacteria and viruses living in the nose, sinuses, or mouth may spread ...

  14. Pulmonary infections in swine induce altered porcine surfactant protein D expression and localization to dendritic cells in bronchial-associated lymphoid tissue

    DEFF Research Database (Denmark)

    Sørensen, C.M.; Holmskov, U.; Aalbæk, B.


    among pSP-D, pathogens, phagocytic cells and dendritic cells. Lung tissue was collected from experimental and natural bronchopneumonias caused by Actinobacillus pleuropneumoniae or Staphylococcus aureus, and from embolic and diffuse interstitial pneumonia, caused by Staph. aureus or Arcanobacterium...

  15. Bibersteinia trehalosi inhibits the growth of mannheimia haemolytica by a proximity-dependent mechanism (United States)

    Mannheimia (Pasteurella) haemolytica is the only pathogen that consistently causes severe bronchopneumonia and rapid death of bighorn sheep (BHS; Ovis canadensis) under experimental conditions. Paradoxically, Bibersteinia (Pasteurella) trehalosi and Pasteurella multocida have been isolated from BHS ...

  16. An Investigation of the Pathology and Pathogens Associated with Porcine Respiratory Disease Complex in Denmark

    DEFF Research Database (Denmark)

    Hansen, Mette Sif; Pors, S. E.; Jensen, H. E.


    Respiratory infections are among the most important diseases of growing pigs. In order to elucidate the multifactorial aetiology of porcine respiratory disease complex (PRDC) in Denmark, lungs from 148 finishing pigs with cranioventral bronchopneumonia (case group) and 60 pigs without lung lesions......), porcine reproductive and respiratory syndrome virus (both European and US type), porcine circovirus type 2 (PCV2), porcine respiratory coronavirus, porcine cytomegalovirus, Mycoplasma hyopneumoniae and Mycoplasma hyorhinis. All cases had cranioventral lobular bronchopneumonia consistent with PRDC....... There was a broad range of microscopical lesions and the cases were characterized as acute (n=10), subacute (n=24) or chronic (n=114) bronchopneumonia. Five bacterial species, five viruses and two Mycoplasma spp. were detected in different combinations. PCV2, M. hyopneumoniae, M. hyorhinis and Pasteurella multocida...

  17. Pattern of Acquired Heart Diseases among Children Seen in Sokoto ...

    African Journals Online (AJOL)

    Endomyocardial fibrosis was seen in 7 (6.4%) patients while infective endocarditis and Kawasaki disease occurred in 6 (5.5%) and 2 (1.8%) patients respectively. Mortality rate was 17.3%. Commonly observed co‑morbidities included heart failure, bronchopneumonia, and pulmonary hypertension. Conclusion: The pattern ...

  18. Clinical Features of Sickle Cell Anaemia in Northern Nigerian Children

    African Journals Online (AJOL)

    Borno and Yobe State has the largest number of sickle cell trait in Nigeria with prevalence of 27.9% and 32.6% respectively. Sickle ... The over-all morbidity pattern is same in both sexes with diseases such as bronchopneumonia, malaria, osteomyelitis, urinary tract infections, septicaemia and septic arthritis being common.

  19. Bordetella bronchiseptica and fatal pneumonia of dogs and cats (United States)

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

  20. Cilia-associated bacteria in fatal Bordetella bronchiseptica pneumonia of dogs and cats (United States)

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

  1. Case Report: Salmonella lung infection | Ohanu | International ...

    African Journals Online (AJOL)

    A case of an 84 year old man admitted because of fever, abdominal discomfort, weakness, past history of cough wheezing and abuse of prednisolone and Erythromycin. He had Bronchopneumonia and diabetes. Salmonella typhimurium was isolated from both his sputum and blood while stool was negative for salmonella.

  2. Serum zinc values in children with congenital heart disease | Sadoh ...

    African Journals Online (AJOL)

    Background: Some children with congenital heart diseases (CHD) may have increased pulmonary blood flow that causes recurrent bronchopneumonia and congestive heart failure. Serum zinc is reduced in children with pneumonia and patients on diuretics. Objective: To evaluate the serum zinc level of children with CHD ...

  3. Underlying congenital heart disease in Nigerian children with ...

    African Journals Online (AJOL)

    Background: Pneumonia is a common cause of childhood morbidity and mortality globally. Some congenital heart disease(CHD) may predispose their sufferer to bronchopneumonia. Objective: To evaluate the contribution of CHD to pneumonia in children seen in a tertiary hospital. Methods: Over a year, consecutive ...

  4. A Comparison Between Doxycycline and Ampicillin in the treatment ...

    African Journals Online (AJOL)

    A Comparison Between Doxycycline and Ampicillin in the treatment of Bronchopneumonia complicating measles. I.R. Lang ... differences in the duration of pyrexia and consolidation are discussed and various conclusions drawn. The results did not correspond with sensitivity tests conducted on swabs taken on admission.


    African Journals Online (AJOL)

    mortality rate was 45%. The deaths were mainly due to laryngeal spasm, septicaemia, bronchopneumonia, and cardiac arrest. The cause of death was either unknown or not documented in 3 patients. Table lzAge and Sex Distribution of the 79 adult tetanus patients. ~ Age groups in YearL <2(L 20-29 $69 4w 50i9 @ lfotal.


    African Journals Online (AJOL)


    Jul 3, 1971 ... Fifty-nine cases of measles with bronchopneumonia as a complication were treated with e'ther doxycycline or am- picillin. The differences in the duration of pyrexia and. consolidaTion are d'scussed and various conclusions drml"ll. The results did not correspond with sensitivity tests CO!1- ducted on swabs ...

  7. Post-neona ta] Medical Admissions into the Paedia trtic Ward of ...

    African Journals Online (AJOL)

    and malignancy (10.0 percent) were major causes of admission, while meningitis (29.4 percent) and cerebral malaria (17.6 percent) were the leading ... based on the final assessment by the managing unit, . and this was often based on the .... complicated by pleural effusion and two by pneumothorax. Bronchopneumonia ...

  8. [Melioidosis: the importance of a detailed medical history, including recent travels].

    NARCIS (Netherlands)

    Snijders, S.L.; Meis, J.F.G.M.; Dofferhoff, A.S.M.


    A 70-year-old woman was admitted to hospital with fever and signs of bronchopneumonia following a recent visit to Southeast Asia. She was diagnosed with melioidosis and treated with ceftazidime i.v. for two weeks, followed by oral co-trimoxazol and folinic acid. She recovered and had no recurring

  9. Trend of HIV-seropositivity among children in a tertiary health ...

    African Journals Online (AJOL)

    Children with clinical diagnosis of bronchopneumonia, neonatal sepsis, septicemia and pulmonary tuberculosis had ... live [7]. With less than 5% of pregnant women in resource-poor countries in sub-Saharan. Africa having access to prenatal testing and preventive treatment, the, burden of pediatric. HIV infection is likely to ...

  10. Behmel syndrome with bilateral posterior ear lobule creases

    African Journals Online (AJOL)

    Rabah M. Shawky


    Sep 8, 2013 ... accessory nipples, hepatomegaly, and congenital heart. The patients have bilateral anterior helical ear pits, and characteristic posterior ear lobule creases. The older one has severe mental retardation and died at the age of 13 months with bronchopneumonia, and the younger one is 7 months old.

  11. Cervical Spine Injury: Nature and Complication | Yiltok | Nigerian ...

    African Journals Online (AJOL)

    Others were bronchopneumonia 9(32.1%); muscle spasms 9 (32.1%). Mortality was 7.1% both from respiratory failure. The mean duration of hospital stay was 95.4 (+78.5; range 0-2210 days. CONCLUSION: The outlook for the cervical injured patient remains bleak. More attention should be devoted to preventive measures ...

  12. D. S. Adeola, C. N. Ononiwu and *S. A. Eguma

    African Journals Online (AJOL)

    Reprint requests to: Dr. D.S. Adeola, Department of Maxillofacial Surgery, Ahmadu Bello University Teaching. Hospital, Kaduna .... Complications. One death resulting from laryngospasm was recorded in the series. Post-operative complications were mainly upper respiration tract infection (112, 22.3%), bronchopneumonia ...

  13. In situ hybridisation for identification and differentiation of Mycoplasma hyopneumoniae, Mycoplasma hyosynoviae and Mycoplasma hyorhinis in formalin-fixed porcine tissue sections

    DEFF Research Database (Denmark)

    Boye, Mette; Jensen, Tim Kåre; Ahrens, Peter


    by cultivation. M. hyopneumoniae and M. hyorhinis were identified in accordance with cultivation in lung sections, from nine pigs affected by catarrhal to purulent bronchopneumonia. Likewise, in eight cases of fibrinous pericarditis, M. hyopneumoniae, M. hyorhinis and M. hyosynoviae were the infectious agents...

  14. Thermal Injury in the Pregnant Patient (United States)


    0.918 28* 16 22 86.0 40.0 Gas heater explosion - - Bronchopneumonia, septicemia 0.974[�* 26 16 90.0 35.0 Propane tank explosion - - Anuria , dilution...hyponatremia 0.983 30* 27 25 92.0 85.5 Gasoline fire - - Anuria , vaginal bleeding 0.987 *From the study done by Taylor and co-workers (8) in 1976. No

  15. Efficacy of a Commercial Bacterin in Protecting Strain 13 Guinea Pigs against Bordetella bronchiseptica Pneumonia. (United States)


    colonies have continued to occur (2-4). In addition to bronchopneumonia, it also induces abortion, still births, infertility, and otitis media (5-7...extract of antigenic material from a highly immunogenic strain of B. bronchiseptica that is recommended for prevention of canine bordetellosis, and as an...aid in controlling canine infectious tracheobronchitis (13). Bacterium: A frozen (-70°C) stock culture of a guLnea pig isolate of B. bronchiseptica

  16. Copper-measurement in a muscle-biopsy. A possible method for postmortem diagnosis of Menkes disease

    DEFF Research Database (Denmark)

    Tønnesen, T.; Müller-Schauenburg, G.; Damsgaard, Else


    A 5-month-old boy showed severe delay in mental and motor development. His hair was normal. He died at 18 months from bronchopneumonia. Autopsy of the brain revealed meningo-cerebral angiodysplasia with tortuous vessels at the surface of the brain. This raised a suspicion of Menkes disease. A mus...... the first time copper-measurements in tissues have been used to establish a post-mortem diagnosis of Menkes disease....

  17. Infecção pelo virus da cinomose com pneumonia secundária por Bordetella bronchiseptica em cães


    Headley, Selwyn Arlington; Graça, Dominguita Lühers; Costa, Mateus Matiuzzi da; Vargas, Agueda Castagna de


    Canine distemper virus infection and secondary Bordetella bronchiseptica pneumonia are described in mongrel dogs. Canine distemper was characterised by nonsuppurative demyelinating encephalitis with typical inclusion bodies in astrocytes. B. bronchiseptica was isolated from areas of purulent bronchopneumonia.São descritas as infecções simultâneas do vírus da cinomose canina e Bordetella bronchiseptica em caninos sem raça definida. As lesões de cinomose foram caracterizadas por encefalite desm...

  18. [Cockayne syndrome in two brothers]. (United States)

    Medeiros, J S; da Silva, E O; de Mello, R J; Fittipaldi, H; de Carvalho, M W


    We report the clinical history of two brothers with the classical Cockayne syndrome. The main manifestations consisted of cachectic dwarfism, mental retardation, intracranial calcifications, microcephaly, enophthalmos, senile appearance, joint hypomotility and skin photosensitivity. In one of these children, who died at 10 years of age of bronchopneumonia, necropsy studies revealed a variety of anomalies, mainly encephalic,which included an arachnoidal cyst at the base of the cerebellum, a defect apparently previously undescribed inpatients with this syndrome.

  19. Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies

    Directory of Open Access Journals (Sweden)

    Alexandre de Matos Soeiro


    Full Text Available INTRODUCTION: Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown. OBJECTIVES: The objective was to describe the demographic data, etiology, and pulmonary histopathological findings of different diseases in the autopsies of patients with acute respiratory failure. METHOD: Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the following data were obtained: age, sex, and major associated diseases. The pulmonary histopathology was categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoplasmacytic interstitial pneumonia. The odds ratio of the concordance between the major associated diseases and specific autopsy findings was calculated using logistic regression. RESULTS: Bacterial bronchopneumonia was present in 33.9% of the cases and cancer in 28.1%. The pulmonary histopathology showed diffuse alveolar damage in 40.7% (1,917 of the cases. A multivariate analysis showed a significant and powerful association between diffuse alveolar damage and bronchopneumonia, HIV/AIDS, sepsis, and septic shock, between liver cirrhosis and pulmonary embolism, between pulmonary edema and acute myocardial infarction, between dilated cardiomyopathy and cancer, between alveolar hemorrhage and bronchopneumonia and pulmonary embolism, and between lymphoplasmacytic interstitial pneumonia and HIV/ AIDS and liver cirrhosis. CONCLUSIONS: Bronchopneumonia was the most common diagnosis in these cases. The most prevalent pulmonary histopathological pattern was diffuse alveolar damage, which was associated with different inflammatory conditions. Further studies are necessary to elucidate the complete pathophysiological mechanisms involved with each disease and the development of acute respiratory failure.

  20. A Histological Assessment of Lung Injury in Rats Exposed to Inhaled Sulfur Mustard across Dose and Time (United States)


    bronchitis, lung fibrosis, productive cough, and chronic obstructive pulmonary disease (Ghanei and Harandi, 2007). Injury can develop slowly, becoming...Throughout the disease time-course regardless of HD dose, the most striking histologic lesions were associated with the conducting airways, i.e., the...humans, following wartime inhalation exposure to HD, reports have identified bronchopneumonia, chest tightness, and in long-term survivors, chronic

  1. Dermatophilus congolensis-associated placentitis, funisitis and abortion in a horse. (United States)

    Sebastian, M M; Giles, R C; Donahu, J M; Sells, S F; Fallon, L; Vickers, M L


    Placentitis, funisitis and fetal bronchopneumonia were diagnosed in an aborted full-term Thoroughbred fetus and its placenta by histopathological examination. Dermatophilus congolensis organisms were isolated from placenta, lung and stomach content. The genotypic identification of aerobic culture was confirmed by sequential analysis of the entire 16S rDNA gene. This is the first report of Dermatophilus congolensis-associated abortion in any species.

  2. Leukocyte adhesion deficiency syndrome: report on the first case in Chile and South America


    Vásquez-De Kartzow, Rodrigo; Jesam, Cristian; Nehgme, Valentina; Várgas, Francisco; Sepúlveda, Carolina


    CONTEXT: Adhesion molecule deficiency type 1 is a rare disease that should be suspected in any patient whose umbilical cord presents delay in falling off, and who presents recurrent severe infections. Early diagnostic suspicion and early treatment improve the prognosis. CASE REPORT: The case of a four-month-old boy with recurrent hospitalizations because of severe bronchopneumonia and several episodes of acute otitis media with non-purulent drainage of mucus and positive bacterial cultures is...

  3. Human transmissible spongiform encephalopathy: Case report


    Duque Velásquez, Camilo; Garzón Álzate, Ánderson; Villegas Lanau, Andrés; Escobar Velásquez, Laura Marcela; Zea Lopera, Julián; Lopera, Francisco; Rodas González, Juan David


    We report the case of a 64 year-old woman with motor and cognitive deterioration that progressed rapidly during eight months. She was unsuccessfully treated with quinacrine, and died in a terminal status, by septic shock secondary to bronchopneumonia by broncho-aspiration. The brain was donated for research and the histopathological analysis showed spongiform changes, astrogliosis and prion protein (PrPRes) deposits, confirmed by Western blot (WB). These features are considered characteristic...

  4. Rickets in black children beyond infancy in Natal

    African Journals Online (AJOL)


    Jul 7, 1995 ... presence of a well-demarcated zone of provisional calcification at the growth plate, while healed ... Dental caries. 3. 1. 3. 0. Hypotonia. 6. 3. 0. 0. Bronchopneumonia. 0. 0. 2. 0. Muscle weakness. 0. 0. 2. 0. Stunting. 6. 11. 10. 3. Table 11. Vitamin 0 deficiency. A1k. 25-. 1,25- phos. Ca2•. PO;-. OHD. (OH),D.

  5. Is survival improved by the use of NIV and PEG in amyotrophic lateral sclerosis (ALS? A post-mortem study of 80 ALS patients.

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    Christian Burkhardt

    Full Text Available Non-invasive ventilation (NIV and percutaneous gastrostomy (PEG are guideline-recommended interventions for symptom management in amyotrophic lateral sclerosis (ALS. Their effect on survival is controversial and the impact on causes of death is unknown.To investigate the effect of NIV and PEG on survival and causes of death in ALS patients.Eighty deceased ALS patients underwent a complete post mortem analysis for causes of death between 2003 and 2015. Forty-two of these patients consented for genetic testing. Effects of NIV and PEG on survival and causes of death were analyzed in a multivariable Cox proportional hazard regression.Six patients, who requested assisted suicide causing drug-induced hypoxia, were excluded from final analysis. Respiratory failure was the main cause of death in 72 out of 74 patients. Fifteen out of 74 died of aspiration pneumonia 23/74 of bronchopneumonia and 8/74 of a combination of aspiration pneumonia and bronchopneumonia. Twenty died of hypoxia without concomitant infection, and six patients had pulmonary embolism alone or in combination with pneumonia. NIV (p = 0.01 and PEG (p<0.01 had a significant impact on survival. In patients using NIV bronchopneumonia was significantly more frequent (p <0.04 compared to non-NIV patients. This effect was even more pronounced in limb onset patients (p<0.002. Patients with C9orf72 hexanucleotide repeat expansions showed faster disease progression and shorter survival (p = 0.01.The use of NIV and PEG prolongs survival in ALS. This study supports current AAN and EFNS guidelines which recommend NIV and PEG as a treatment option in ALS. The risk of bronchopneumonia as cause of death may be increased by NIV.

  6. Epizootic Pneumonia of Bighorn Sheep following Experimental Exposure to Mycoplasma ovipneumoniae (United States)

    Besser, Thomas E.; Cassirer, E. Frances; Potter, Kathleen A.; Lahmers, Kevin; Oaks, J. Lindsay; Shanthalingam, Sudarvili; Srikumaran, Subramaniam; Foreyt, William J.


    Background Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis). The cause of this disease has been a subject of debate. Leukotoxin expressing Mannheimia haemolytica and Bibersteinia trehalosi produce acute pneumonia after experimental challenge but are infrequently isolated from animals in natural outbreaks. Mycoplasma ovipneumoniae, epidemiologically implicated in naturally occurring outbreaks, has received little experimental evaluation as a primary agent of bighorn sheep pneumonia. Methodology/Principal Findings In two experiments, bighorn sheep housed in multiple pens 7.6 to 12 m apart were exposed to M. ovipneumoniae by introduction of a single infected or challenged animal to a single pen. Respiratory disease was monitored by observation of clinical signs and confirmed by necropsy. Bacterial involvement in the pneumonic lungs was evaluated by conventional aerobic bacteriology and by culture-independent methods. In both experiments the challenge strain of M. ovipneumoniae was transmitted to all animals both within and between pens and all infected bighorn sheep developed bronchopneumonia. In six bighorn sheep in which the disease was allowed to run its course, three died with bronchopneumonia 34, 65, and 109 days after M. ovipneumoniae introduction. Diverse bacterial populations, predominantly including multiple obligate anaerobic species, were present in pneumonic lung tissues at necropsy. Conclusions/Significance Exposure to a single M. ovipneumoniae infected animal resulted in transmission of infection to all bighorn sheep both within the pen and in adjacent pens, and all infected sheep developed bronchopneumonia. The epidemiologic, pathologic and microbiologic findings in these experimental animals resembled those seen in naturally occurring pneumonia outbreaks in free ranging bighorn sheep. PMID:25302992

  7. Is survival improved by the use of NIV and PEG in amyotrophic lateral sclerosis (ALS)? A post-mortem study of 80 ALS patients. (United States)

    Burkhardt, Christian; Neuwirth, Christoph; Sommacal, Andreas; Andersen, Peter M; Weber, Markus


    Non-invasive ventilation (NIV) and percutaneous gastrostomy (PEG) are guideline-recommended interventions for symptom management in amyotrophic lateral sclerosis (ALS). Their effect on survival is controversial and the impact on causes of death is unknown. To investigate the effect of NIV and PEG on survival and causes of death in ALS patients. Eighty deceased ALS patients underwent a complete post mortem analysis for causes of death between 2003 and 2015. Forty-two of these patients consented for genetic testing. Effects of NIV and PEG on survival and causes of death were analyzed in a multivariable Cox proportional hazard regression. Six patients, who requested assisted suicide causing drug-induced hypoxia, were excluded from final analysis. Respiratory failure was the main cause of death in 72 out of 74 patients. Fifteen out of 74 died of aspiration pneumonia 23/74 of bronchopneumonia and 8/74 of a combination of aspiration pneumonia and bronchopneumonia. Twenty died of hypoxia without concomitant infection, and six patients had pulmonary embolism alone or in combination with pneumonia. NIV (p = 0.01) and PEG (pALS. This study supports current AAN and EFNS guidelines which recommend NIV and PEG as a treatment option in ALS. The risk of bronchopneumonia as cause of death may be increased by NIV.

  8. [Expression and significance of adhesion molecules CD62P and CD44 in peripheral blood of infants with bronchiolitis]. (United States)

    Zou, Li-Ping; Wang, Wei; Zhang, Yan-Li; Zhang, Yan; Wang, Li


    To explore the expression and significance of the adhesion molecules CD62P and CD44 in the peripheral blood of infants with bronchiolitis. Thirty-three infants with bronchiolitis in the acute phase and 19 infants with bronchiolitis in the recovery phase, who were hospitalized between November 2014 and May 2015, were enrolled. Thirty infants with bronchopneumonia and 26 infants without infection were enrolled as the bronchopneumonia group and the control group, respectively. The CD62P expression in the peripheral blood of each group was measured by flow cytometry, and the CD44 level in serum was determined using ELISA. The levels of the adhesion molecules CD62P and CD44 in the bronchiolitis group in the acute phase were significantly higher than those in the bronchiolitis group in the recovery phase, the bronchopneumonia group, and the control group (Pbronchiolitis group in the recovery phase were also significantly higher than those in the control group (Pbronchiolitis group in the acute phase, there was a positive correlation between CD62P expression and serum CD44 level (r=0.91; Pbronchiolitis, and their levels can reflect the severity of inflammatory response in infants with bronchiolitis.

  9. Endogenous lipoid pneumonia in a cachectic patient after brain injury. (United States)

    Zhang, Ji; Mu, Jiao; Lin, Wei; Dong, Hongmei


    Endogenous lipoid pneumonia (EnLP) is an uncommon non-life-threatening inflammatory lung disease that usually occurs in patients with conditions such as lung cancers, primary sclerosing cholangitis, and undifferentiated connective tissue disease. Here we report a case of EnLP in a paralytic and cachectic patient with bronchopneumonia after brain injury. A 40-year-old man experienced a severe brain injury in an automobile accident. He was treated for 1 month and his status plateaued. However, he became paralyzed and developed cachexia and ultimately died 145 days after the accident. Macroscopically, multifocal yellowish firm nodules were visible on scattered gross lesions throughout the lungs. Histologically, many foam cells had accumulated within the alveoli and alveolar walls accompanied by a surrounding interstitial infiltration of lymphocytes. The findings were in accordance with a diagnosis of EnLP. Bronchopneumonia was also noted. To our knowledge, there have been few reports of EnLP associated with bronchopneumonia and cachexia after brain injury. This uncommon pathogenesis should be well recognized by clinicians and forensic pathologists. The case reported here should prompt medical staff to increase the nutritional status and fight pulmonary infections in patients with brain injury to prevent the development of EnLP.

  10. Pneumonia in slaughtered sheep in south-western Iran: pathological characteristics and aerobic bacterial aetiology

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    Shahrzad Azizi


    Full Text Available In this study, the lungs of 1,000 sheep carcasses were subjected to gross examination and those suspected to be infected with pneumonia were studied at histopathological level as well as examined for presence of bacteria. Pneumonia was detected in 42 (4.2% carcasses. Based on histopathological lesions, 45.24% were affected with suppurative bronchopneumonia, 20.93% with interstitial pneumonia, 11.9% bronchointerstitial pneumonia, 7.14% with fibrinous bronchopneumonia and 2.38% with embolic pneumonia. In addition, 11.9% of the lungs showed lung abscesses and 2.33% were affected with pleuritis without involving pulmonary parenchyma. Bacteriological examination revealed presence of ovine pathogens, such as Pasteurella multocida (24.53%, Staphylococcus aureus (20.75%, Klebsiella pneumoniae (15.09%, Corynebacterium pseudotuberculosis (7.55% and Actinomyces pyogenes (1.89%. The most common form of pneumonia was suppurative bronchopneumonia with moderate amounts of fibrin deposits on the pleural surface and inside the bronchioles and alveoli.

  11. Fatal diquat intoxication

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    Jović-Stošić Jasmina


    Full Text Available Background. Since the introduction of diquat in agriculture practice in 1960's, about 40 cases of poisoning have been described in detail in medical literature. Case report. We presented two cases. A case one, a 35-year-old, previously healthy, woman ingested 14% diquat solution. The poisoning had fulminant course, consisted of severe stomachache, vomiting, cardiocirculatory shock, respiratory failure and cardiac arrest 20 hours post-ingestion. Autopsy revealed myocardial infarction, bronchopneumonia and incipient renal damage. A case two, a 64-year-old man developed severe gastroenteritis, corrosive lesions of mucosal surfaces, acute renal injury, arrhythmias, brain stem infarction and bronchopneumonia. The diagnosis of diquat poisoning was made retrospectively upon the clinical picture and identification of pesticides he had been exposed to. The patient died 18 days post-exposure. The most prominent findings on autopsy were pontine hemorrhage and infarction, bronchopneumonia, left ventricle papillary muscle infarction and renal tubular damage. Conclusion. Cardiocirculatory disturbances led to fatal complications, the heart and brain infarction. We pointed out the heart as one of the most severely affected organs in diquat poisoning.

  12. [Incidence and mortality of common neonatal diseases in the foal during the first 10 days post natum in a veterinary hospital]. (United States)

    Graßl, Martin; Ulrich, Tina; Wehrend, Axel


    The aim of this study was to present the incidence and lethality of diseases in foals during the first 10 days following birth by analyzing patient data. Over a period of 6 years, patient data from 393 foals, that had been presented within the first 10 days after birth in a hospital, were evaluated. The number of diseases, the sex of the affected foals and the lethality were documented. A total of 28 diseases were diagnosed, with systemic inflammatory response syndrome (SIRS), meconium impaction and bronchopneumonia being the most frequent diagnoses. The mortality rate for SIRS was 41.8%, for meconium impaction 29.7% and for bronchopneumonia 37.9%. The mean time of death for patients with SIRS was 4.2   ±   2.9 days, for patients with meconium impaction 4.6 ± 3.2 days and for foals suffering from bronchopneumonia 5.2    ±   3.5 days post partum. Based on the data collection, the frequency and thus the importance of individual disease patterns can be deduced. The information on lethality helps to make predictions for the prognosis of the most common neonatal foal diseases based on first diagnosis.

  13. [Death in the bathtub--rectal drug administration]. (United States)

    Musshoff, F; Dettmeyer, R; Madea, B


    A young nurse was found dead in a bathtub. An autopsy revealed the following results: pulmonary emphysema, severe edema of both lungs, transudation in both pleural cavities. Conspicuous were skin sticks of a white wax material. In chemical-toxicological analysis diazepam, tetrazepam and phenobarbital were detected in this material. After anal-rectal and additionally oral ingestion the following blood concentrations were determined: BAC 0.03/1000; diazepam 500 ng/ml; nordiazepam 65 ng/ml; tetrazepam 180 ng/ml; phenobarbital 9.4 mg/l. In connection with this drug effects an acute, multifocal, suppurating bronchopneumonia in both lungs was revealed as the cause of death.

  14. Canine distemper virus infection with secondary Bordetella bronchiseptica pneumonia in dogs Infecção pelo virus da cinomose com pneumonia secundária por Bordetella bronchiseptica em cães

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    Selwyn Arlington Headley


    Full Text Available Canine distemper virus infection and secondary Bordetella bronchiseptica pneumonia are described in mongrel dogs. Canine distemper was characterised by nonsuppurative demyelinating encephalitis with typical inclusion bodies in astrocytes. B. bronchiseptica was isolated from areas of purulent bronchopneumonia.São descritas as infecções simultâneas do vírus da cinomose canina e Bordetella bronchiseptica em caninos sem raça definida. As lesões de cinomose foram caracterizadas por encefalite desmielinizante associada a corpúsculos de inclusão em astrócitos. B. bronchiseptica foi isolada das áreas com broncopneumonia supurativa.

  15. Disseminated visceral coccidiosis in whooping cranes (United States)

    Carpenter, J.W.; Spraker, T.R.; Novilla, M.N.


    Three 13- to 18-day-old whooping cranes (Grus americana) and a 9-year-old whooping crane died in outdoor pens at the Patuxent Wildlife Research Center. The deaths were associated with an overwhelming systemic infection by an intracellular protozoan parasite, which resulted in enteritis, granulomatous bronchopneumonia, hepatitis, splenitis, and myocarditis. The clinical, histopathologic, and electron microscopic findings were similar to those in sandhill cranes (Grus canadensis) at the Patuxent Center found to be infected with Eimeria reichenowi and E gruis. Since these eimerian species also parasitize wild whooping cranes, this parasite might be an important pathogenic agent for this species.

  16. Granulomatous Pancreatitis in a Patient with Acute Manifested Insulin-Dependent Diabetes Mellitus

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    Václav Mandys


    Full Text Available Isolated granulomatous noncaseating pancreatitis is a rare condition exceptionally described in human population. We demonstrate a case of the a 71-years-old female patient suffering from recent diabetes mellitus, generalized atherosclerosis and hypertension who died due to pulmonary embolism and terminal bronchopneumonia. Lipomatosis of pancreatic tissue was observed during the postmortem examination. Histological examination of pancreatic tissue discovered multiple small noncaseating epithelioid cell and giant cell granulomas, partly replacing the islets of Langerhans. To our knowledge, our case represents the first description of noninfectious granulomatous pancreatitis associated with acute manifested insulin-dependent diabetes mellitus.

  17. The origin of Pasteurella multocida impacts pathology and inflammation when assessed in a mouse model

    DEFF Research Database (Denmark)

    Pors, Susanne E.; Chadfield, Mark S.; Sorensen, Dorte B.


    ) of an isolate from porcine pneumonia or fowl cholera showed marked differences between the two isolates. The avian isolate was highly pathogenic with severe signs of necrotizing pneumonia, liver necrosis and high bacterial load in lung and liver. Clinical signs and pathology related to the porcine isolate were...... dose dependent and consisted of exudative bronchopneumonia, abscess formation in liver and a lower bacterial load in lung and liver. Both isolates caused increased expression of MMP9 and TIMP1. In conclusion, evaluation and comparison of pathogenicity and host-pathogen interaction of P. multocida...

  18. Human transmissible spongiform encephalopathy: Case report

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    Duque Velásquez, Camilo


    Full Text Available We report the case of a 64 year-old woman with motor and cognitive deterioration that progressed rapidly during eight months. She was unsuccessfully treated with quinacrine, and died in a terminal status, by septic shock secondary to bronchopneumonia by broncho-aspiration. The brain was donated for research and the histopathological analysis showed spongiform changes, astrogliosis and prion protein (PrPRes deposits, confirmed by Western blot (WB. These features are considered characteristic of prion diseases, which are uncommon in Colombia. We highlight that its diagnosis was made for the first time in this country by the simultaneous use of immunohistochemistry and Western blot.

  19. Non-typeable Haemophilus influenzae purulent pericarditis in a child with cystic fibrosis. (United States)

    Downes, Kevin J; Abulebda, Kamal; Siracusa, Christopher; Moore, Ryan; Staat, Mary A; Poynter, Sue E


    Early airway colonization and infection with Haemophilus influenzae in children with cystic fibrosis (CF) is common. Although the pathogenicity of non-typeable H. influenzae (NTHi) in patients with CF is controversial, this organism can cause both upper and lower respiratory tract infections. Extra-pulmonary disease, however, is rare. Purulent pericarditis is a suppurative complication of bacterial infection of the pericardial space that can arise as a result of direct extension from an adjacent infection. We describe a case of purulent pericarditis due to NTHi in a young child with CF that developed as a complication of inadequately treated bronchopneumonia. © 2016 Japan Pediatric Society.

  20. Parasites in harbour seals ( Phoca vitulina) from the German Wadden Sea between two Phocine Distemper Virus epidemics (United States)

    Lehnert, K.; Raga, J. A.; Siebert, U.


    Parasites were collected from 107 harbour seals ( Phoca vitulina) found on the coasts of Schleswig-Holstein, Germany, between 1997 and 2000. The prevalence of the parasites and their associated pathology were investigated. Eight species of parasites, primarily nematodes, were identified from the examined organs: two anisakid nematodes ( Pseudoterranova decipiens (sensu lato) , Contracaecum osculatum (sensu lato)) from the stomach, Otostrongylus circumlitus (Crenosomatidae) and Parafilaroides gymnurus (Filaroididae) from the respiratory tract, one filarioid nematode ( Acanthocheilonema spirocauda) from the heart, two acanthocephalans, Corynosoma strumosum and C. semerme (Polymorphidae), from the intestine and an ectoparasite, Echinophthirius horridus (Anoplura, Insecta). Lungworm infection was the most prominent parasitological finding and secondary bacterial bronchopneumonia the most pathogenic lesion correlated with the parasites. Heavy nematode burdens in the respiratory tract were highly age-related and more frequent in young seals. A positive correlation was observed between high levels of pulmonary infection and severity of bronchopneumonia. The prevalence of lungworms in this study was higher than in seals that died during the 1988/1989 Phocine Distemper Virus epidemic, and the prevalence of acanthocephalans and heartworms had decreased compared to findings from the first die-off.

  1. Comparative virulence of Haemophilus parasuis serovars 1 to 7 in guinea pigs. (United States)

    Rapp-Gabrielson, V J; Gabrielson, D A; Schamber, G J


    Reference strains for Haemophilus parasuis serovars 1 to 7 were examined for virulence by inoculation of guinea pigs. Guinea pig response to intraperitoneal inoculation was similar for the 7 reference strains. However, apparent differences in virulence were detected after intratracheal inoculation. Cells of the references strains for serovars 1 and 5 were most invasive, causing moribundity or death at higher doses and a persistent septicemia at lower doses. Haemophilus parasuis could be isolated from respiratory and systemic sites; purulent bronchopneumonia, pericarditis, and pleuritis were apparent in infected guinea pigs. Inoculation of cells of the reference strains for serovars 2 and 6 also resulted in bronchopneumonia and moribundity or death in some guinea pigs; however, reisolation of H parasuis and microscopic lesions at necropsy were less pronounced than those observed with serovars 1 and 5. Inoculation of cells of serovars 3, 4 and 7 induced only transient clinical signs and minimal evidence of H parasuis infection at necropsy. The data from intratracheal inoculation of guinea pigs are similar to data from other investigations in swine, indicating differences in the pathogenic potential of H parasuis strains. Thus, guinea pigs may be useful as a laboratory animal model for examining cellular factors associated with virulence and immunogenicity of H parasuis.

  2. Immunoglobulin concentration in blood serum of postcolostral calves: Ratio between immunoglobulin level and appearance of enzootic pneumonia

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    Jonić Branko


    Full Text Available The timely supply of newborn calves with optimal quantities of colostrum has a key role in the process of immune protection in the early phase of their lives. Passively acquired antibodies can protect the digestive organs from infection caused by E.coli bacteria, and it seems also from the appearance of diseases of the respiratory tract. These examinations were performed on a cattle farm where bronchopneumonia was one of the most significant health problems, and a group of 39 calves were selected for the investigations. The calves were fed with their mothers’ colostrum after birth, and then with collective milk. Immunoglobulin concentration was determined in blood samples taken during the postcolostral period, with the method using zinc-sulphate. At the age of 40 days, the calves were administered a polyvalent inactivated vaccine, and revaccinated 20 days after that (Vibak, Veterinary Department Subotica. In 74.34% calves, the immunoglobulin G concentration ranged from 26 to 40 g/l. In 25.66% calves, the immunoglobulin concentration was lower, from 8 to 25 g/l. The calves found to have a lower concentration of immunoglobulin in blood contracted bronchopneumonia more frequently, and the outcome of the disease in some cases was mortality, even.

  3. Pasteurella multocida type A as the primary agent of pneumonia and septicaemia in pigs

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    João X. de Oliveira Filho


    Full Text Available Abstract: In order to understand better the pathological aspects and spread of Pasteurella multocida type A as the primary cause of pneumonia in pigs, was made an experiment with intranasal inoculation of different concentrations of inocula [Group (G1: 108 Colony Forming Units (CFU/ml; G2: 107 CFU/ml; G3: 106 CFU/ml and G4: 105 CFU/ml], using two pigs per group. The pigs were obtained from a high health status herd. Pigs were monitored clinically for 4 days and subsequently necropsied. All pigs had clinical signs and lesions associated with respiratory disease. Dyspnoea and hyperthermia were the main clinical signs observed. Suppurative cranioventral bronchopneumonia, in some cases associated with necrosuppurative pleuropneumonia, fibrinous pericarditis and pleuritic, were the most frequent types of lesion found. The disease evolved with septicaemia, characterized by septic infarctions in the liver and spleen, with the detection of P. multocida type A. In this study, P. multocida type A strain #11246 was the primary agent of fibrinous pleuritis and suppurative cranioventral bronchopneumonia, pericarditis and septicaemia in the pigs. All concentrations of inoculum used (105-108 CFU/ml were able to produce clinical and pathological changes of pneumonia, pleuritis, pericarditis and septicemia in challenged animals.

  4. Pneumonia and bacteremia in a golden-headed lion tamarin (Leontopithecus chrysomelas) caused by Klebsiella pneumoniae subsp. pneumoniae during a translocation program of free-ranging animals in Brazil. (United States)

    Bueno, Marina G; Iovine, Renata O; Torres, Luciana N; Catão-Dias, José L; Pissinatti, Alcides; Kierulff, Maria C M; Carvalho, Vania M


    Klebsiella pneumoniae is an important emerging pathogen in humans, particularly the invasive hypermucoviscosity (HMV) phenotype. In addition, the organism is an important public health concern because of nosocomial infections and antimicrobial resistance. Nonhuman primates in captivity are susceptible to Klebsiella, particularly when a stress factor is involved. Infections vary depending on the species but can cause significant morbidity and mortality in these animals. The objective of this study was to describe a case of bronchopneumonia and bacteremia caused by Klebsiella pneumoniae in a free-ranging golden-headed lion tamarin (Leontopithecus chrysomelas) caught and maintained in quarantine during a translocation program for conservation purposes. An adult male, that had showed emaciation and apathy, was clinically examined and, despite being provided supportive therapy, died 2 days after onset of clinical signs. At postmortem examination, generalized bilateral pneumonia and pericarditis were observed. Tissue samples were fixed in 10% formalin for histology, and pulmonary tissues and cardiac blood were collected for microbiologic diagnostic procedures. Bacteria that were shown to be HMV K. pneumoniae subsp. pneumoniae strains were isolated from the pulmonary fluids and cardiac blood in pure cultures. Severe bronchopneumonia was the main pathological finding. The consequences of the confirmed presence of the HMV phenotype of K. pneumoniae subsp. pneumoniae in this wildlife species for human, animal, and ecosystem health should be determined. These results demonstrate the importance of quarantine and potential pathogen screening during wildlife translocation procedures. © 2015 The Author(s).

  5. Computed tomography of the thorax in calves from birth to 105 days of age. (United States)

    Ohlerth, S; Augsburger, H; Abé, M; Ringer, S; Hatz, L; Braun, U


    The present study was undertaken to provide computed tomographic (CT) reference values for structures in the thorax of the calf. Six clinically healthy Holstein-Friesian calves were anaesthetized. Transverse pre- and postcontrast images with a reconstructed 1.5-mm slice thickness were obtained using a multislice-CT scanner at 6 different time points from birth to 105 days of age. Absolute and relative measurements of the trachea, heart, cranial and caudal vena cava, thoracic aorta, right and left principal bronchi, right and left caudal lobar bronchi and the accompanying branches of the right and left pulmonary artery and vein, thoracic lymph nodes and lung density were taken for every time point. All animals were euthanized after the last CT scan, and 4 calves were frozen to generate an atlas comparing gross anatomy with CT. During the study, 4 animals temporarily showed coughing and mucopurulent nasal discharge, and mild to moderate bronchopneumonia and pleuritis were diagnosed using CT. Animals recovered with treatment; however, mild to moderate CT changes remained throughout the study. Even in the 2 clinically normal animals, mild bronchopneumonia was diagnosed on CT.

  6. An outbreak of fatal hemorrhagic pneumonia caused by Streptococcus equi subsp. zooepidemicus in shelter dogs. (United States)

    Byun, Jae Won; Yoon, Soon Seek; Woo, Gye-Hyeong; Jung, Byeong Yeal; Joo, Yi-Seok


    An outbreak of fatal hemorrhagic pneumonia with 70-90% morbidity and 50% mortality occurred in an animal shelter in Yangju, Gyeonggi Province, Korea. Clinically, the affected dogs showed severe respiratory distress within 48 h after arriving in the shelter. The dead were found mainly with nasal bleeding and hematemesis. At necropsy, hemothorax and hemorrhagic pneumonia along with severe pulmonary consolidation was observed, though histopathological analysis showed mainly hemorrhagic bronchopneumonia. Lymphoid depletion was inconsistently seen in the spleen, tonsil and bronchial lymph node. Gram-positive colonies were shown in blood vessels or parenchyma of cerebrum, lung, liver, spleen, and kidney. Also, Streptococcus (S.) equi subsp. zooepidemicus was isolated from the various organs in which the bacterium was microscopically and histologically detected. In addition, approximately 0.9 Kb specific amplicon, antiphagocytic factor H binding protein, was amplified in the bacterial isolates. In this study, we reported an outbreak of canine hemorrhagic bronchopneumonia caused by S. equi subsp. zooepidemicus in an animal shelter in Yangju, Korea.

  7. Inclusões intracitoplasmáticas hialinas na medular da adrenal de bovinos

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    L.P Mesquita


    Full Text Available Cytoplasmic inclusion bodies in adrenal medullary chromaffin cells have been described in various species including humans. These inclusions are believed to be related to certain infectious, toxic and neurodegenerative diseases. No reports concerning such adrenal inclusions have been described in bovines. Adrenal glands from twenty bovines were evaluated in a retrospective study. Seven of these exhibited inclusions - three cases of rabies, two cases of chronic suppurative bronchopneumonia, one case of chronic suppurative peritonitis, and one case of gangrenous mastitis. The inclusions were present in higher numbers especially in cases of rabies and also in one case of chronic suppurative bronchopneumonia. The inclusions were intracytoplasmic, eosinophilic, rounded, single or multiple, of various sizes, strongly stained by PAS and were present in higher numbers in the external layer of the adrenal medulla. The inclusions were negative when subjected to immunohistochemistry for detection of viral antigens in the cases of rabies. Although inclusion bodies were present in adrenal glands devoid of other histological alterations, they were more abundant in cases in which the adrenal gland had other alterations. The correlation between certain diseases and the development of inclusion bodies is not known, which highlights the importance of further studies on these inclusions in adrenal glands of bovines.

  8. [The impact of domestic violence on children's health]. (United States)

    Arcos, Estela; Uarac, Myrna; Molina, Irma


    There is close association between maltreatment during pregnancy and child abuse after birth. To compare anthropometric growth and use of health services of children whose mothers suffered maltreatment with children coming from families without domestic violence. A longitudinal study of two cohorts. An index groups formed by 76 children whose mothers experienced maltreatment and control group of 46 children coming from families without domestic violence. Data was obtained from patient files in private health centers. Respiratory diseases were the most prevalent cause of consultation and hospital admission. Children in the index group had a 2.8 times higher risk of bronchopneumonia in the post natal period and a poor attendance to health care controls. In four children, cerebral contusion was registered as the cause of hospital admission. Domestic violence is associated with a higher risk of respiratory diseases and hospital admissions in children. New strategies are necessary to detect and prevent child abuse and neglect.

  9. Normal sweat chloride test does not rule out cystic fibrosis. (United States)

    Başaran, Abdurrahman Erdem; Karataş-Torun, Nimet; Maslak, İbrahim Cemal; Bingöl, Ayşen; Alper, Özgül M


    Başaran AE, Karataş-Torun N, Maslak İC, Bingöl A, Alper ÖM. Normal sweat chloride test does not rule out cystic fibrosis. Turk J Pediatr 2017; 59: 68-70. A 5-month-old patient presented with complaints of fever and cough. He was hospitalized with the diagnosis of bronchopneumonia and pseudo-Bartter's syndrome. Patient was further investigated for diagnosis of cystic fibrosis. The chloride (Cl) level in sweat was determined within the normal range (25.1 mmol/L, 20.3 mmol/L). CFTR (Cystic Fibrosis Transmembrane Regulator gene; NM_000492.2) genotyping results were positive for p.E92K; p.F1052V mutations. The patient was diagnosed with cystic fibrosis. In our patient, with features of CF and normal sweat test, mutation analysis was helpful for the diagnosis of cystic fibrosis.

  10. Pathological findings and probable causes of the death of Stejneger's beaked whales (Mesoplodon stejnegeri) stranded in Japan from 1999 and 2011. (United States)

    Tajima, Yuko; Maeda, Kaori; Yamada, Tadasu K


    One hundred and twenty stranding events of Stejneger's beaked whales were reported in Japan between 1999 and 2011. The purpose of this study is to introduce pathological data and to discuss probable causes of death for 44 Stejneger's beaked whales among them. The significant pathological findings were the pulmonary edema, parasitic granulomatous nephritis, emaciation, amyloidosis, suppurative bronchopneumonia and so on. The probable causes of death were categorized as noninfectious in 43 of the cases, which included drowning, starvation and secondary amyloidosis. One individual was diagnosed with septicemia, which was the only example of an infectious disease. Because we could not always perform advanced analyses, such as microbiology tests, biotoxin examinations or contaminant analyses, the finality of our findings may be impaired. However, the present study has broad implications on the causes of death of Stejneger's beaked whales of the seas around Japan, which are valuable for the future studies and for the detection of emerging diseases.

  11. Total lymphoid irradiation in refractory systemic lupus erythematosus

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    Ben-Chetrit, E.; Gross, D.J.; Braverman, A.; Weshler, Z.; Fuks, Z.; Slavin, S.; Eliakim, M.


    In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second patient developed massive bronchopneumonia, necrotic cutaneous lesions, and progressive nephritis and died 2 weeks after completion of radiotherapy. These observations, although limited to two patients, indicate that total lymphoid irradiation in patients with severe systemic lupus erythematosus should be regarded as strictly experimental.

  12. A Case of Fatal Congenital Human Immunodeficiency Virus Infection

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    Halil Uğur Hatipoğlu


    Full Text Available Acquired immune deficiency syndrome is a clinical condition caused by human immunodeficiency virus (HIV which can be transmitted either vertically or horizontally. More than 90% of children living with HIV in developing countries have been infected through mother to child transmission during pregnancy, around the time of birth, or through breastfeeding. In order to reduce the number of infected children, increasing emphasis should be placed on preventing mother to child transmission programs with the use of antiretroviral medications in the pregnant woman during pregnancy and at delivery and, starting immediately after birth for the exposed infant. Here, we present the case of a 60-day-old infant heavily immunocompromised due to an extremely high viral burden of HIV, which was acquired perinatally from an undiagnosed and untreated mother, leading to severe bronchopneumonia, sepsis, septic shock and death.

  13. Cuterebrid myiasis (Diptera: Oestridae) in captive ring-tailed lemurs (Lemur catta) at a South Carolina zoo. (United States)

    Tuten, Holly C; Miller, Heather C; Ellis, Angela E


    In September 2008, two ring-tailed lemurs (Lemur catta), comprising a mother-daughter pair, at the Greenville Zoo, Greenville, South Carolina, USA, were diagnosed with cuterebrid myiasis (Diptera: Oestridae) subsequent to sudden death of the adult lemur. On necropsy, a single bot warble was discovered in the subcutis of the axillary region. Histopathology revealed a severe eosinophilic bronchopneumonia. The juvenile lemur was inspected and found to have warbles on three separate dates in late September. One representative bot fly larva was identified as a Cuterebra sp. that normally infests lagomorphs in the southeastern United States. Cuterebrid myiasis is rarely reported in lemurs and has not been previously associated with pneumonia or death in these animals.

  14. Aspergillus-Related Lung Disease

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    Alia Al-Alawi


    Full Text Available Aspergillus is a ubiquitous dimorphic fungus that causes a variety of human diseases ranging in severity from trivial to life-threatening, depending on the host response. An intact host defence is important to prevent disease, but individuals with pre-existing structural lung disease, atopy, occupational exposure or impaired immunity are susceptible. Three distinctive patterns of aspergillus-related lung disease are recognized: saprophytic infestation of airways, cavities and necrotic tissue; allergic disease including extrinsic allergic alveolitis, asthma, allergic bronchopulmonary aspergillosis, bronchocentric granulomatosis and chronic eosinophilic pneumonia; and airway and tissue invasive disease -- pseudomembranous tracheobronchitis, acute bronchopneumonia, angioinvasive aspergillosis, chronic necrotizing aspergillosis and invasive pleural disease. A broad knowledge of these clinical presentations and a high index of suspicion are required to ensure timely diagnosis and treatment of the potentially lethal manifestations of aspergillus-related pulmonary disease. In the present report, the clinical, radiographic and pathological aspects of the various aspergillus-related lung diseases are briefly reviewed.

  15. Immunohistochemical study of porcine lung lesions associated with Pasteurella multocida

    DEFF Research Database (Denmark)

    Pors, Susanne Elisabeth; Hansen, Mette Sif; Bisgaard, Magne


    Infectious bronchopneumonia is a widespread disease in modern commercial pig production and Pasteurella multocida is frequently associated with the lesions. To evaluate porcine lung lesions associated with P. multocida, populations of inflammatory cells were examined by immunohistochemistry...... by immunohistochemistry were T-lymphocytes (CD3(+), CD4(+) and CD8(+) subsets), B-lymphocytes, neutrophils, macrophages, and IgA(+), IgM(+) and IgG(+) cells. The results showed that (1) a significant increase in all inflammatory cells was found in lesions associated with P. multocida, (2) necrotic lesions had a larger....... The results show that P. multocida significantly alters the inflammatory response in the lung and that lesions associated with P. multocida display diverse inflammatory responses according to their distinct morphological pattern....

  16. [Respiratory infections associated with a cytomegalovirus]. (United States)

    Calicó, I; Moraga Llop, F A; Español, T; Bertrán Sangués, J M; Fernández Pérez, F


    We report 27 children with respiratory tract disease in whom cytomegalovirus was isolated. These group excludes transplant patients and those on hemodialysis and mononucleosis. At the time of virus studies 7 had pneumonia, 3 chronic bronchopneumopathy, 2 bronchopneumonia, 8 pertussoid syndrome, 6 bronchitis or bronchiolitis and 1 laryngitis with glottic oedema. Virus studies consisted in cell cultures of biological products (pharyngeal exudates and urine). They were positive in 18 pharyngeal exudates, 24 urines, 2 bronchial brushings and 1 bronchoaspiration. In only 5 patients a complete serologic study was performed, with 3 seroconversions and one case of persistent high titers. Three patients had severe immune disease (2 hipogammaglobulinemias) and 1 dysgammaglobulinemia. These findings are discussed.

  17. Chest X-Ray Findings of Sputum Positive Tuberculosis Patients in Rafsanjan City

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    H. Farahmand


    Full Text Available Plain chest x- ray is the first imaging modality for suspected tuberculosis patients because it is available, sensitive and inexpensive . The aim of this study was to identify the plain x- ray findings in sputum positive tuberculosis patients . One hundred and fourteen plain chest films of sputum positive tuberculosis patients that referred to health center of Rafsanjan were evaluated between 1988 and 1996 . This investigation was a retrospective cross sectional study that showed 92% of the cases had positive radiographic findings and 8% had normal chest x- ray. The most commom radiographic findings was exudative (pneumonic tubercolosis of lungs and other radiographic findings with decreasing frequency include: cavitation , fibro productive tuberculosis , pleural effusion, calcification, bronchopneumonia , atelectasis , lymphadenopathy bronchectasis and miliary tuberculosis.

  18. A Case Report of a Patient with Leukocyte Adhesion Deficiency Type I Syndrome and Normal Time of Umbilical Cord Detachment

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    M. Safari


    Full Text Available Introduction: Leukocyte adhesion deficiency type 1 is a rare disorder of function of neutrophils which presents with recurrent bacterial and fungal infections. The patients usually have a history of delayed umbilical cord detachment. Case Report: The patient was a fourteen-month-old boy with recurrent bronchopneumonia, skin abscess and oral candidiasis. There was a history of abscess formation in site of vaccine injection in two and four months of age. The umbilical cord detachment was occurred in the 6th day of birth. Laboratory studies showed marked leukocytosis and neutrophilia .Flowcytometry showed low amount of CD18. These were all compatible with a diagnosis of leukocyte adhesion deficiency type I (LADs1. Conclusions: The patients die in the event of a delay in diagnosis because of recurrent severe infections. Early diagnosis and treatment of these diseases by stem cell transplantation improve the survival of the patient. (Sci J Hamadan Univ Med Sci 2016; 23 (1:88-92

  19. Postmortem findings in collared peccaries raised in captivity in northeastern Brazil

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    Jael S. Batista


    Full Text Available This study is a retrospective examination of diseases in collared peccaries that were diagnosed by the Veterinary Pathology Laboratory, Universidade Federal Rural do Semiárido. Necropsy and histological examination were performed from 2005 to 2010. Of the 50 necropsied collared peccaries, 24% died due to restraint and capture myopathy; 18% died from trauma; and the remainder was diagnosed with splenic hemangioma (6%, enterolithiasis (6%, gastritis (6%, gastric ulcer (4%, intestinal volvulus (4%, gastric volvulus (2%, mammary carcinoma (2%, polycystic kidney disease (2%, pyometra (2%, and suppurative bronchopneumonia (2%. Twelve animals remained undiagnosed, seven of which (14% were in advanced autolytic condition and five of which (10% had no gross or microscopic lesions that were compatible with disease. This paper describes illnesses that have not been reported in the collared peccary, focusing on their clinical and pathological aspects.

  20. Unexpected death in patients suffering from eating disorders. A medico-legal study. (United States)

    Rajs, J; Rajs, E; Lundman, T


    Medico-legal investigation into causes of unexpected death of five persons who suffered from eating disorders did not give distinct pathoanatomical explanations. The analysis disclosed a number of risk factors whose interplay may have resulted in a circulatory catastrophy. These factors were of organisational and ideological character: simultaneous treatment at different departments, lack of contact with psychiatrists, or unclear criteria for admission to hospital; or somatic: circulatory and electrocardiographic S-T and T wave abnormalities, hypopotassemia and hypoglycemia, as well as anergy of the emaciated patient which may have led to symptoms of bronchopneumonia being overlooked. Morphological investigation revealed heart atrophy as well as recent lesions such as haemorrhages, fragmentation and contraction bands of the myofibres. In two extremely emaciated patients there was a disproportion between the size of the mitral valves and the atrophic ventricular wall, an appearance similar to "floppy valves". In one instance an erroneously inserted gastric tube contributed to vomiting, hypopotassemia and sudden death.

  1. Tracheobronchomegaly with multiple diverticula: a case report

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    Park, Chan Sup; Kim, Joung Sook [College of Medicine, Inha University, Incheon (Korea, Republic of)


    Chest radiograhs revealed evidences of dilatation of the trachea and both main bronchi, multiple air bubbles around the trachea and focal bronchopneumonia in right lower lobe. Tracheobronchomegaly is a rare condition characterized by marked dilatation of the trachea and main bronchi and frequently associated with tracheal diverticulosis, bronchiectasis, and recurrent lower respiratory tract infection. Mounier-Kuhn, in 1932, was the first to associate the presence of tracheobronchomegaly with the clinical syndrome of chronic, recurrent respiratory tract infection. Tracheobronchomegaly is believed to be extremely rare. To date, only 92 cases have been reported in the literatures. We recently encountered a case of tracheobronchomegaly associated with multiple diverticula formation. The diagnosis was made by chest radiography, computed tomography (CT), bronchography, and CT taken immediately after the bronchography.

  2. Pneumonia due to Chlamydia pecorum in a Koala (Phascolarctos cinereus). (United States)

    Mackie, J T; Gillett, A K; Palmieri, C; Feng, T; Higgins, D P


    Chlamydiosis is a common infectious disease of koalas (Phascolarctos cinereus), but Chlamydia spp. have not yet been demonstrated to cause pneumonia in these animals. A juvenile male koala died following an episode of respiratory disease. At necropsy examination, the lung tissue was consolidated. Microscopical lesions in the lung included pyogranulomatous bronchopneumonia, proliferation of bronchiolar and alveolar epithelium and interstitial fibrosis. Hyperplastic bronchiolar epithelial cells contained aggregates of small basophilic punctate organisms, which were confirmed as chlamydiae by transmission electron microscopy and immunohistochemistry. Real-time polymerase chain reaction identified these as Chlamydia pecorum. This report provides the best evidence to date of chlamydial infection causing pneumonia in a koala, and the first evidence that C. pecorum is capable of infecting the bronchiolar epithelium of the koala. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Pathology of experimental infection by Pasteurella multocida serotype A: 1 in buffalo calves. (United States)

    Praveena, P E; Periasamy, S; Kumar, A A; Singh, N


    Pasteurella multocida serotype A:3 has been mostly implicated in pneumonic pasteurellosis in ruminants. In contrast, our previous studies have reported that both serotypes A:1 and A:3 were responsible for respiratory diseases in cattle and buffaloes. However, the pathology and pathogenesis of P. multocida serotype A:1 (Pm A:1) infection have not been studied in ruminants. In the present study, 12- to 15-week-old buffalo calves (Bubalus bubalis) infected by Pm A:1 had fibrinous and suppurative bronchopneumonia with focal areas of coagulation necrosis typical of pneumonic pasteurellosis. For the first time, this study reports the lung pathology and pathogenecity of Pm A:1 infection in calves. © The Author(s) 2014.

  4. Alpha- 1 Antitrypsin Deficiency in Children: Pulmonary Involvement

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    Mohammad Esmaeili


    Full Text Available Introduction: α1-antitrypsin deficiency (α1-ATD is one of the most common genetic disorders in white race, a usual cause of liver disease in children, and hepatopulmonary involvement in children and adult. The aim of this case description is presenting a child with early lung disease without liver parenchymal disorder. Case presentation: We describe a 13 year old boy because of exertional dyspnea, wheezing, productive cough and repeated hospital admission due to bronchopneumonia. There was no immune deficiency, sinusitis and allergic lung disease. There was no history of foreign body aspiration. Cystic fibrosis cause ruled out. Protein electrophoresis and serum level α1-AT evaluation documented α1-ATD. The patient was treated with conservative management. Conclusion: This article suggests that if a child presents with chronic pulmonary symptoms, possibility of α1-ATD should be considered and worked up.

  5. Pulmonary nocardiosis with osteomyelitis; Nocardiose pulmonaire compliquee d'osteomyelite

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    Bechet, R.; Granier, P.; Mourad, M. [Centre Hospitalier Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France); Dufranc, A. [Centre Hospitalier Antoine-Gayraud, Service de Pneumologie, 11 - Carcassonne (France); Adoue, D. [Centre Hospitalier Antoine-Gayraud, Service de Medecine Interne et Immunopathologie Clinique, 11 - Carcassonne (France)


    We report a case of a 49-year-old female who developed a bronchopneumonia associated with atelectasis of the upper right lobe and back pain of bone origin. Bronchoscopy revealed an endobronchial mass at the origin of the right upper lobe bronchus. Scintigraphy showed three paravertebral spots of the seventh and eighth thoracic vertebrae, without any radiological modification. Culture of lung tissue obtained by trans-parietal punction under CT scan control became positive to Nocardia belonging to the pneumoniae complex. Positive diagnosis of pulmonary nocardiosis associated with two rare localizations was set, one was an endobronchial mass, the other was osteomyelitis of the posterior chest wall. The patient was treated with Trimethoprim ulfamethoxazole and recovered completely. (author)

  6. Leukocyte adhesion deficiency syndrome: report on the first case in Chile and South America

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    Rodrigo Vásquez-De Kartzow

    Full Text Available CONTEXT: Adhesion molecule deficiency type 1 is a rare disease that should be suspected in any patient whose umbilical cord presents delay in falling off, and who presents recurrent severe infections. Early diagnostic suspicion and early treatment improve the prognosis. CASE REPORT: The case of a four-month-old boy with recurrent hospitalizations because of severe bronchopneumonia and several episodes of acute otitis media with non-purulent drainage of mucus and positive bacterial cultures is presented. His medical history included neonatal sepsis and delayed umbilical cord detachment. Laboratory studies showed marked leukocytosis with predominance of neutrophils and decreased CD11b and CD18. These were all compatible with a diagnosis of leukocyte adhesion deficiency type I [LAD type 1].

  7. Mycoplasma bovis associated with decubital abscesses in Holstein calves. (United States)

    Kinde, H; Daft, B M; Walker, R L; Charlton, B R; Petty, R


    Between April of 1990 and March of 1992, calves on a Holstein calf ranch experienced subcutaneous decubital abscesses involving the brisket region, dorsal aspect of the carpus, and lateral aspect of the stifle joints. Fifty out of 2,500 (2%) Holstein calves between the ages of 3 and 12 weeks were affected. Needle aspirates of brisket abscesses from 8 calves and 6 live or dead calves with 1 or more decubital abscesses were submitted for examination. Two of the 6 calves in addition had bronchopneumonia. Mycoplasma bovis was isolated from all abscesses and 1 lung. Formalin fixed tissues taken from the affected areas also revealed M. bovis by immunoperoxidase staining. No evidence of joint involvement was apparent, and no mycoplasma was isolated from the joints adjacent to affected areas. Attempts to isolate mycoplasma from milk and environmental samples were unsuccessful.

  8. Hypervirulent Klebsiella pneumoniae in California Sea Lions ( Zalophus californianus): Pathologic Findings in Natural Infections. (United States)

    Seguel, Mauricio; Gottdenker, Nicole L; Colegrove, Kathleen; Johnson, Shawn; Struve, Carsten; Howerth, Elizabeth W


    Tissues of stranded California sea lions ( Zalophus californianus) naturally infected with a hyperviruluent strain of Klebsiella pneumoniae were examined by histopathology and immunohistochemistry against the K. pneumoniae K2 capsular antigen. In 7 of 8 animals, there was severe purulent bronchopneumonia, sometimes complicated by fibrinonecrotizing pleuritis with pyothorax. In affected areas of lung, large numbers of degenerate neutrophils and macrophages were admixed with rare large extracellular and intracellular gram-negative bacilli surrounded by a prominent capsule. Through serotyping, polymerase chain reaction, sequencing, and immunohistochemistry, these bacteria were confirmed to be a K2 serotype of K. pneumoniae. The same bacteria were identified through double immunolabeling within macrophages in blood vessels, lymph nodes, spleen, and liver. Intact K. pneumoniae were identified on epithelial surfaces of the nasopharyngeal, tracheal, and small intestine mucosae and within distal renal tubules. Our findings indicate that hypervirulent K. pneumoniae causes severe respiratory disease and intrahistiocytic bacteremia in California sea lions.

  9. Morphologic studies of the pathogenesis of naturally occurring porcine circovirus type 2 diseases in pigs

    DEFF Research Database (Denmark)

    Hansen, Mette Sif

    ) and experimental models of PCVDs are reviewed. In chapter 3, the results achieved by the research are presented as four manuscripts (I-IV): Manuscript I is focussed on the presence of PCV2 and viral replication, in the bone marrow and thymus of experimentally infected pigs and pigs naturally affected...... by postweaning multisystemic wasting syndrome (PMWS). By in situ hybridization (ISH) virus and viral replication was detected, mainly in histiocyte-like cells, in both organs of the PMWSaffected pigs. However, there was no evidence that bone marrow or thymus is especially important in regard of PCV2 replication....... In manuscript II the occurrence and tissue distribution of PCV2 is examined, by immunohistochemistry (IHC) of lungs, kidneys, lymph nodes and spleen from slaughtered Danish finishing pigs with or without bronchopneumonia. Detection of PCV2 could not be related to lesions or PCVD. The virus was mainly detected...

  10. Barbiturate ingestion in three adult captive tigers (Panthera tigris and concomitant fatal botulism of one : clinical communication

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    J. H. Williams


    Full Text Available Zoo animals, including tigers, have been reported to suffer from barbiturate intoxication, with pentabarbitone being most commonly recorded. Clinical signs range from mild ataxia to general anaesthesia with recovery over hours to days with several factors affecting hepatic barbiturate metabolism and tissue partitioning. Botulism is an often fatal intoxication in man, animals, birds and certain fish. The occurrence in carnivores is uncommon to rare, with only 2 reports found of botulism in felids. This report relates to 3 adult captive cohabiting tigers that simultaneously developed signs of abdominal discomfort, progressive ataxia, recumbency and comatose sleep resembling stage 2 anaesthesia, alternating with periods of distracted wakefulness and ataxic movements. These signs occurred 4 days after being fed the carcass of a horse that had ostensibly died of colic and not been euthanased. The male tiger that was the dominant animal in the feeding hierarchy was worst affected and had to be given intravenous fluids. The female that was lowest in hierarchy was unaffected. After 48-72 hours of treatment at the Onderstepoort Veterinary Academic Hospital the females could eat and made an uneventful recovery. The male tiger showed partial recovery but died during the night a few hours after drinking water on his return to the owner. Necropsy revealed severe oesophageal dilation and impaction with decaying grass; some of this material and water were present in the pharynx and trachea, and had been aspirated causing acute widespread bronchopneumonia. Colon content tested negative for common pesticides but, together with liver, tested positive for barbiturate. Serum taken on the day of admission had tested negative for barbiturate and the residual serum from the 3 animals later tested negative for botulinum toxin. Colon and oesophageal content from the male at necropsy were positive for Clostridium botulinum toxin type C by the mouse bioassay

  11. Barbiturate ingestion in three adult captive tigers (Panthera tigris) and concomitant fatal botulism of one. (United States)

    Williams, J H; Bester, L; Venter, L; Pretorius, D; Greyling, F


    Zoo animals, including tigers, have been reported to suffer from barbiturate intoxication, with pentabarbitone being most commonly recorded. Clinical signs range from mild ataxia to general anaesthesia with recovery over hours to days with several factors affecting hepatic barbiturate metabolism and tissue partitioning. Botulism is an often fatal intoxication in man, animals, birds and certain fish. The occurrence in carnivores is uncommon to rare, with only 2 reports found of botulism in felids. This report relates to 3 adult captive cohabiting tigers that simultaneously developed signs of abdominal discomfort, progressive ataxia, recumbency and comatose sleep resembling stage 2 anaesthesia, alternating with periods of distracted wakefulness and ataxic movements. These signs occurred 4 days after being fed the carcass of a horse that had ostensibly died of colic and not been euthanased. The male tiger that was the dominant animal in the feeding hierarchy was worst affected and had to be given intravenous fluids. The female that was lowest in hierarchy was unaffected. After 48-72 hours of treatment at the Onderstepoort Veterinary Academic Hospital the females could eat and made an uneventful recovery. The male tiger showed partial recovery but died during the night a few hours after drinking water on his return to the owner. Necropsy revealed severe oesophageal dilation and impaction with decaying grass; some of this material and water were present in the pharynx and trachea, and had been aspirated causing acute widespread bronchopneumonia. Colon content tested negative for common pesticides but, together with liver, tested positive for barbiturate. Serum taken on the day of admission had tested negative for barbiturate and the residual serum from the 3 animals later tested negative for botulinum toxin. Colon and oesophageal content from the male at necropsy were positive for Clostridium botulinum toxin type C by the mouse bioassay neutralisation test, confirming

  12. Difference of clinical features in childhood Mycoplasma pneumoniae pneumonia

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    Kang Jin-Han


    Full Text Available Abstract Background M. pneumoniae pneumonia (MP has been reported in 10-40% of community-acquired pneumonia cases. We aimed to evaluate the difference of clinical features in children with MP, according to their age and chest radiographic patterns. Methods The diagnosis of MP was made by examinations at both admission and discharge and by two serologic tests: the indirect microparticle agglutinin assay (≥1:40 and the cold agglutinins titer (≥1:32. A total of 191 children with MP were grouped by age: ≤2 years of age (29 patients, 3-5 years of age (81 patients, and ≥6 years of age (81 patients. They were also grouped by pneumonia pattern: bronchopneumonia group (96 patients and segmental/lobar pneumonia group (95 patients. Results Eighty-six patients (45% were seroconverters, and the others showed increased antibody titers during hospitalization. Among the three age groups, the oldest children showed the longest duration of fever, highest C-reactive protein (CRP values, and the most severe pneumonia pattern. The patients with segmental/lobar pneumonia were older and had longer fever duration and lower white blood cell (WBC and lymphocyte counts, compared with those with bronchopneumonia. The patient group with the most severe pulmonary lesions had the most prolonged fever, highest CRP, highest rate of seroconverters, and lowest lymphocyte counts. Thrombocytosis was observed in 8% of patients at admission, but in 33% of patients at discharge. Conclusions In MP, older children had more prolonged fever and more severe pulmonary lesions. The severity of pulmonary lesions was associated with the absence of diagnostic IgM antibodies at presentation and lymphocyte count. Short-term paired IgM serologic test may be mandatory for early and definitive diagnosis of MP.

  13. Histopathological and immunohistochemical approaches for the diagnosis of Pasteurellosis in swine population of Punjab

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    Payal Bhat


    Full Text Available Aim: Infectious porcine bronchopneumonia, caused by Pasteurella multocida, is a widespread disease of major economic significance. Thus, the aim of the present study was to diagnose swine Pasteurellosis using gross, histopathological, and immunopathological approaches in the swine population of Punjab and to compare the efficacy of immunohistochemical (IHC techniques with conventional diagnostic techniques. Materials and Methods: A total of 71 adult swine lung samples showing gross pneumonic changes were collected along with the associated lymph nodes to carry out the study. The collected samples were then processed for histopathological and IHC studies. Results: Out of the total 71 lung samples, 26 samples were found to be suspected for Pasteurellosis as per the microscopic changes observed, and out of these 26 samples, 16 cases were confirmed to be positive for Pasteurellosis by IHC. Varied macroscopic changes noted in lungs were pneumonic patches with consolidation of many lobes, congestion, and focal hemorrhages. Main lesions associated with lymph nodes were its enlargement and hemorrhages. Histologically, the lung showed fibrinous and suppurative bronchopneumonia, multifocal suppuration, thickening of septa with fibrin combined with cellular infiltration and edema. The higher IHC expression of P. multocida was seen in the bronchial epithelium besides in alveolar and bronchial exudate. Moreover, on comparing the histopathological and IHC scores which were calculated on the basis of characteristic microscopic lesions and number of antigen positive cells, respectively, a significant positive correlation (r=0.4234 was found. Conclusion: It was concluded that swine population of Punjab is having P. multocida infection. The gross and histopathological lesions can be helpful in the preliminary diagnosis of Pasteurellosis but needs to be supplemented by other immunodiagnostic tests. Moreover, IHC technique proved to be a specific, reliable, precise

  14. Clinical Characteristic and Outcome of Acute Lower Respiratory Tract Infection in Children with Congenital Heart Disease

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    Krystle Gabriela


    Full Text Available Background: Acute Lower Respiratory Tract Infection (ALRTI is the leading cause of deaths in children under 5 years of age worldwide, and has high morbidity and mortality in children with Congenital Heart Disease (CHD. The objective of this study was to obtain the incidence, clinical characteristic, and outcome of ALRTI children with CHD. Methods: A retrospective hospital-based study was conducted from January 2007–December 2011 to medical record of child patients with ALRTI and CHD in the Department of Child Health of Dr. Hasan Sadikin General Hospital, Bandung. The diagnosis of CHD was determined by echocardiography. The collected data was analyzed and presented in percentage shown in tables. Results : From 3,897 children who had ALRTI, there were 149 children with CHD (3.8%, with 11.4% of whom founded with recurrent episodes. This happened often in girls than boys with quite similar ratio of 1.37: 1.The majority of children (80% was under 1 year old of age, 72.5% with malnutrition, and 24.8% with severe malnutrition. Clinical symptoms mostly found were difficulty of breathing (98%, fever (85.2%, cough (75.2%, and runny nose (63.1%. The most common types of CHD were Patent Ductus Arteriosus (47.6%, followed by Ventricular Septal Defect (47%. Bronchopneumonia (86.6% was the common type of ALRTI. The length of stay was mostly less than 10 days (70.5%. From all the children 43.7% had complications, and 6.7% died. Conclusions: The ALRTI in children with CHD is not common and has good outcome. The majority for CHD lesions are Patent Ductus Arteriosus and Ventricular Septal Defect while for ALRTI is Bronchopneumonia.

  15. Clinical efficacy of florfenicol in the treatment of calf respiratory tract infections. (United States)

    Aslan, V; Maden, M; Erganis, O; Birdane, F M; Corlu, M


    This paper reports on a study of the aetiology of calf pneumonia and the clinical efficacy of florfenicol, a new antibiotic in Turkey. Twenty-seven weaned and unweaned calves (13 males and 14 females) between 1 and 16 months of age brought to the clinics of Selçuk University, Faculty of Veterinary Science. Broncho-alveolar lavage (BAL) fluid samples were taken from the animals diagnosed to have upper respiratory tract infection associated with bronchitis (N=2), bronchitis (N=5), bronchopneumonia (N=4), pneumonia (N=3), pleuropneumonia (N=11), bronchopneumonia plus pulmonary oedema (N=2) based on the results of the clinical and laboratory examinations. Then microbiological isolation and antibiotic culturing were performed. The animals were treated with 1 ml/15 kg (20 mg/kg) florfenicol (Nuflor, DIF) twice within 48 hours via intramuscular injection. At the end of the treatment, 23 of the weaned and unweaned calves were completely healed, 1 calf had died and 3 calves showed no healing. The results of BAL samples and microbiological examinations of the 3 calves that did not respond to the treatment indicated that these cases were affected by mixed infections of yeasts, fungi, and bacteria. Widespread pleuropneumonia was observed. According to the results of the microbiological examination of the BAL samples, Mannheimia (Pasteurella) haemolytica had the highest isolation rate (25%) compared with the other isolated bacteria, namely, Klebsiella pneumonia (20%), Actinomyces pyogenes (15%), beta-hemolytic streptococci. (10%), Staphylococcus spp. (5%), and E. coli (5%). The study also revealed fungi [Penicillum spp. (5%) and Aspergillus spp. (5%)] and two calves (10%) had a yeast infection.. We conclude that florfenicol has a high bacteriological and clinical efficacy (100% and 96% respectively) in the treatment of calf respiratory tract diseases.

  16. Paciente com paralisa cerebral coreoatetoide: evolução clínica pós-intervenção Patient with choreoathetoid cerebral palsy: post therapeutic intervention

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    Carolina Castelli Silvério


    cerebral palsy, three years and three months old on average, under speech therapy. Data related to staff classification (FOIS scale; dysphagia degree; bronchopneumonia, airway secretions and weight; food consistency; suggestive signs of tracheal aspiration. Data were collected in their medical records before and after therapeutic intervention. RESULTS: data related to FOIS scale indicated that before and after therapeutic intervention, the majority of the patients were in V level, with reduction in the second moment. Increase of the patients in the III and IV levels. After therapeutic intervention, there was reduction of the patients who had liquid foods, increase the use of Jelly-O and homogenic pasty. The severity of dysphagia was reduced as well as the incidence of bronchopneumonia and airway secretions, increase in weight and a reduction of suggestive signs of tracheal aspiration. CONCLUSION: speech and language therapy intervention, together with the work of a multidisciplinary dysphagia team, promotes better swallowing efficacy and security, with a decrease in suggestive signs of tracheal aspiration, bronchopneumonia and weight increase.

  17. Pneumonia enzoótica em javalis (Sus scrofa Enzootic pneumonia in wild boars (Sus scrofa

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    Roselene Ecco


    presented reduced growth rate, anorexia, lethargy, cough and dyspnea, especially after they were moved. High body temperature (40ºC in average was verified in some animals. Auscultation revealed moderate pulmonary crepitation and stertors. Pulmonary gross lesions were typical of lobular bronchopneumonia. Lung lesions were characterized by ventral-cranial consolidation in the majority of the cases. The color of affected pulmonary areas varied from diffuse dark red to mosaic pattern (dark red lobule intercalate by grayish lobule or diffusely grayish. The majority of the lungs had mucopurulent exsudate in the bronchial lumen that also drained from the parenchyma cut surface. Upon microscopy, the changes were characterized by purulent and histiocytic bronchopneumonia with necrotic foci. In some animals, there was BALT hyperplasia associated with perivascular and peribronchial plasma cells and lymphocytes infiltration in most of these cases. Bordetella bronchiseptica and Streptococcus spp. were the most frequently isolated bacteria. Immunohistochemistry evaluation demonstrated Mycoplasma hyopneumoniae on the luminal surface of bronchial and bronchiolar epithelial cells, and the DNA of bacteria was detected by PCR. This is the first report of bronchopneumonia in wild boars associated with M. hyopneumoniae infection.

  18. Immune defense of rats immunized with fennel honey, propolis, and bee venom against induced staphylococcal infection. (United States)

    Sayed, S M; Abou El-Ella, Ghada A; Wahba, Nahed M; El Nisr, Neveen A; Raddad, Khaled; Abd El Rahman, M F; Abd El Hafeez, M M; Abd El Fattah Aamer, Ahmed


    The objective of this work was to evaluate the potency of bee product-immunized rats to overcome an induced Staphylococcus aureus infection. Forty rats were divided to eight groups: T1, T3, and T5 received, respectively, fennel honey, ethanol, and aqueous propolis extracts orally, and T2, T4, and T6 were administered the respective materials intraperitoneally; T7 received bee venom by the bee sting technique; and T8 was the control group. All groups were challenged by a bovine clinical mastitis isolate of S. aureus. Each rat received 2 mL of broth inoculated with 1 x 10(5) colony-forming units/mL intraperitoneally. Two weeks post-induced infection all rats were sacrificed and eviscerated for postmortem inspection and histopathological study. Three rats from T8 and one rat from T7 died before sacrifice. Another two rats, one each in T4 and T5, had morbidity manifestations. The remaining experimental animals showed apparently healthy conditions until time of sacrifice. Postmortem inspection revealed that all T8 rats showed different degrees of skeletal muscle and internal organ paleness with scattered focal pus nodules mainly on lungs and livers. All rats of the treated groups showed normal postmortem features except three rats. A dead rat in group T7 showed focal pus nodules on the lung surface only, whereas the affected two rats in groups T4 and T5 appeared normal except with some pus nodules, but much smaller than in the control, scattered on the hepatic surface and mesentery. Histopathological studies revealed that T8 rats had typical suppurative bronchopneumonia and or severe degenerative and necrobiotic changes in hepatic tissues. Three affected rats of the treated groups showed slight bronchopneumonia or degenerative hepatic changes only. The other animals of the treated groups showed completely normal parenchymatous organs with stimulated lymphatic tissues. It was concluded that all tested previously bee product-immunized rats could significantly challenge

  19. Interaction of lipocalin 2, transferrin, and siderophores determines the replicative niche of Klebsiella pneumoniae during pneumonia. (United States)

    Bachman, Michael A; Lenio, Steven; Schmidt, Lindsay; Oyler, Jennifer E; Weiser, Jeffrey N


    Pathogenic bacteria require iron for replication within their host. Klebsiella pneumoniae and other Gram-negative pathogens produce the prototypical siderophore enterobactin (Ent) to scavenge iron in vivo. In response, mucosal surfaces secrete lipocalin 2 (Lcn2), an innate immune protein that binds Ent to disrupt bacterial iron acquisition and promote acute inflammation during colonization. A subset of K. pneumoniae isolates attempt to evade Lcn2 by producing glycosylated Ent (Gly-Ent, salmochelin) or the alternative siderophore yersiniabactin (Ybt). However, these siderophores are not functionally equivalent and differ in their abilities to promote growth in the upper respiratory tract, lungs, and serum. To understand how Lcn2 exploits functional differences between siderophores, isogenic mutants of an Ent(+) Gly-Ent(+) Ybt(+) K. pneumoniae strain were inoculated into Lcn2(+/+) and Lcn2(-/-) mice, and the pattern of pneumonia was examined. Lcn2 effectively protected against the iroA ybtS mutant (Ent(+) Gly-Ent(-) Ybt(-)). Lcn2(+/+) mice had small foci of pneumonia, whereas Lcn2(-/-) mice had many bacteria in the perivascular space. The entB mutant (Ent(-) Ybt(+) Gly-Ent(-)) caused moderate bronchopneumonia but did not invade the transferrin-containing perivascular space. Accordingly, transferrin blocked Ybt-dependent growth in vitro. The wild type and the iroA mutant, which both produce Ent and Ybt, had a mixed phenotype, causing a moderate bronchopneumonia in Lcn2(+/+) mice and perivascular overgrowth in Lcn2(-/-) mice. Together, these data indicate that Lcn2, in combination with transferrin, confines K. pneumoniae to the airways and prevents invasion into tissue containing the pulmonary vasculature. Gram-negative bacteria are a common cause of severe hospital-acquired infections. To cause disease, they must obtain iron and secrete the small molecule enterobactin to do so. Animal models of pneumonia using Klebsiella pneumoniae indicate that enterobactin promotes

  20. Pulmonary infections in swine induce altered porcine surfactant protein D expression and localization to dendritic cells in bronchial-associated lymphoid tissue (United States)

    Soerensen, Charlotte M; Holmskov, Uffe; Aalbaek, Bent; Boye, Mette; Heegaard, Peter M; Nielsen, Ole L


    Surfactant protein D (SP-D) is a pattern-recognition molecule of the innate immune system that recognizes various microbial surface-specific carbohydrate and lipid patterns. In vitro data has suggested that this binding may lead to increased microbial association with macrophages and dendritic cells. The aim of the present in vivo study was to study the expression of porcine SP-D (pSP-D) in the lung during different pulmonary bacterial infections, and the effect of the routes of infection on this expression was elucidated. Furthermore, the aim was to study the in vivo spatial relationship among pSP-D, pathogens, phagocytic cells and dendritic cells. Lung tissue was collected from experimental and natural bronchopneumonias caused by Actinobacillus pleuropneumoniae or Staphylococcus aureus, and from embolic and diffuse interstitial pneumonia, caused by Staph. aureus or Arcanobacterium pyogenes and Streptococcus suis serotype 2, respectively. By comparing normal and diseased lung tissue from the same lungs, increased diffuse pSP-D immunoreactivity was seen in the surfactant in both acute and chronic bronchopneumonias, while such increased expression of pSP-D was generally not present in the interstitial pneumonias. Co-localization of pSP-D, alveolar macrophages and bacteria was demonstrated, and pSP-D showed a patchy distribution on the membranes of alveolar macrophages. SP-D immunoreactivity was intracellular in dendritic cells. The dendritic cells were identified by their morphology, the absence of macrophage marker immunoreactivity and the presence of dendritic cell marker immunoreactivity. Increased expression of pSP-D in the surfactant coincided with presence of pSP-D-positive dendritic cells in bronchus-associated lymphoid tissue (BALT), indicating a possible transport of pSP-D through the specialized M cells overlying (BALT). In conclusion, we have shown that pSP-D expression in the lung surfactant is induced by bacterial infection by an aerogenous route rather

  1. Medico-legal examination of hanging

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    Mehmet Beşir Yıldırım


    Full Text Available Hanging is usually fatal and it is one of the most preferred method of suicide due to can be applied easily at any environment. In hanging particularly serious injuries is seen on the neck structures. Vascular injuries, cervical spine injury, laryngeal, tracheal injury can be seen or cerebral edema, intracranial hemorrhage can be occurred secondary to neck injury. In survivors of hanging, epilepsy, pulmonary complications such as acute respiratory distress syndrome, pulmonary edema, and bronchopneumonia are frequently observed. Hanging is a serious health problem that requires urgent intervention and post-professional care. Hanging has a high mortality despite early and accurate intervention. However the relief of neck structures and the treatment of accompanying complications can increase survival. In this study, we aimed that once again attract attention one of the most preferred way of suicide hanging cases, raise awareness of community on this issue and emphasize the importance of the early interventions in patients with near hanging. J Clin Exp Invest 2015; 6 (4: 400-405

  2. A novel herpesvirus associated with respiratory disease in Bourke's parrots (Neopsephotus bourkii). (United States)

    Shivaprasad, H L; Phalen, D N


    A novel herpesvirus infection in nine Bourke's parrots (Neopsephotus bourkii, formerly Neophema bourkii) housed in an outdoor aviary comprised of multiple species of birds was diagnosed based on histopathology, electron microscopy and polymerase chain reaction (PCR). Clinical signs in the parrots included anorexia, ruffled feathers, depression, loss of weight and respiratory distress. The most common gross lesions were moderately congested and oedematous lungs and a mild fibrinous exudate in the air sacs and lumen of the trachea. Histological examination revealed mild to severe bronchopneumonia and airsacculitis with syncytial cells containing eosinophilic intranuclear inclusion bodies in most birds. Other less frequent changes included tracheitis, syringitis, sinusitis, rhinitis, otitis media and conjunctivitis. Attempts to culture the virus in chicken embryos and chicken embryo liver cells were unsuccessful. Examination by transmission electron microscopy of syncytial cells from the lungs of two birds revealed intranuclear virus particles typical of the family Herpesviridae. DNA from a novel herpesvirus was amplified from lung tissue by PCR using degenerate primers derived from conserved avian herpesvirus sequences. The virus belongs in the genus Iltovirus of the Alphaherpesvirinae subfamily. It is not closely related to Psittacid herpesvirus 1 that causes Pacheco's disease but does group phylogenetically with a clade of herpesviruses that cause respiratory disease in a number of avian species. The proposed name for this herpesvirus is Psittacid herpesvirus 3.

  3. Rabies among African wild dogs (Lycaon pictus) in the Masai Mara, Kenya. (United States)

    Kat, P W; Alexander, K A; Smith, J S; Richardson, J D; Munson, L


    A pack of African wild dogs (Lycaon pictus) ranging to the north of the Masai Mara National Reserve in southwestern Kenya was monitored from 1988 to 1989. During a 6-week period (August 1-September 13, 1989), 21 of 23 members of this pack died. Seven carcasses were retrieved, of which 4 were suitable for necropsy and histopathologic examination. Gross findings varied among individuals and included multiple bite wounds, synovitis, lymphadenopathy, submandibular, cervical, and vocal cord edema, blood in bronchi, bronchioles, stomach, and intestine, and interioventral lung lobe consolidation. Histologic examination of 2 available brain samples revealed nonsuppurative encephalitis with eosinophilic intracytoplasmic inclusions (Negri bodies). An additional brain sample tested positive for rabies via a fluorescent antibody test. Other histologic features included severe suppurative bronchopneumonia, myocarditis, and lymphoid depletion of the lymph nodes, tonsils, and spleen. A 304-base pair (bp) nucleotide sequence from the N gene and a 310-bp sequence from the G gene from rabies isolates of 4 wild dogs indicated that infection was with a rabies variant common among domestic dogs in Kenya and Tanzania.

  4. Bronchiolitis Obliterans Organizing Pneumonia in Swine Associated with Porcine Circovirus Type 2 Infection

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    Ching-Chang Cheng


    Full Text Available Bronchiolitis obliterans organizing pneumonia (BOOP is a chronic respiratory disease. Although the pathogenesis of BOOP is still incompletely understood, BOOP is responsive to steroids and has a good prognosis. In our five pigs with chronic postweaning multisystemic wasting syndrome (PMWS, typical BOOP lesions were revealed. All five porcine lungs showed typical intraluminal plugs, and porcine circovirus type 2 (PCV2 was identified. They also exhibited similar pathologic findings such as proliferation of type II pneumocytes and myofibroblasts (MFBs, extracellular collagen matrix (ECM deposition, and fragmentation of elastic fibers. MFBs migration correlative molecules, for instance, gelatinase A, B and osteopontin, appeared strongly in the progressing marginal area of polypoid intraluminal plugs of fibrotic lesion. These molecules colocalized with the active MFBs. Both gelatinase activity and intercellular level of active MFBs were significantly increased (<.05. Porcine chronic bronchopneumonia leads to BOOP and it is associated with PCV2 persistent infection. Swine BOOP demonstrates similar cellular constituents with human BOOP. Perhaps their molecular mechanisms of pathogenesis operate in a similar way. Thus we infer that the swine BOOP can be considered as a potential animal model for human BOOP associated with natural viral infection. Moreover, it is more convenient to obtain samples.

  5. Infecção por Chryseobacterium indologenes: relato de um caso Chryseobacterium indologenes infection: a case report

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    Renata de Souza Ferreira


    Full Text Available Relatamos um caso de infecção por Chryseobacterium indologenes, presente na cultura de aspirado traqueal em paciente sob ventilação mecânica invasiva, revisando os aspectos epidemiológicos, microbiológicos e o tratamento na unidade de terapia intensiva. Paciente do sexo masculino, 30 anos, internado com quadro de aplasia de medula idiopática e neutropenia febril foi transferido para a unidade de terapia intensiva com quadro de broncopneumonia e sepse grave de origem pulmonar. A maioria dos casos já relatados de pacientes com infecção por Chryseobacterium indologenes apresentavam patologias graves associadas e infecções polimicrobianas que podem dificultar a interpretação da efetividade da terapia antimicrobiana contra este agente.A case of Chryseobacterium indologenes infection is reported, identified in an invasive mechanic ventilation patient's tracheal aspiration material. Epidemiological, microbiological, and intensive care unit therapy aspects are discussed. The patient was a 30 years-old male, admitted with idiopathic medullary aplasia and febrile neutropenia, referred to the intensive care unit with severe bronchopneumonia and sepsis of pulmonary origin. Most of the previously reported Chryseobacterium indologenes infection cases were associated with severe diseases and polymicrobial infections which could make difficult interpreting antimicrobial therapy options against this agent.

  6. First report of immunohistochemical detection of Peste des petit ruminants, parainfluenza 3 and respiratory syncytial viral antigens in lungs of Nigerian goats. (United States)

    Jarikre, Theophilus Aghogho; Emikpe, Benjamin Obukowho


    This study determined the of involvement of PPR, PI3, and RS viruses in the pathology of caprine pneumonia across Nigeria. 150 goats were selected randomly. PI3 and RSV monoclonal antibodies and PPR polyclonal antibody were used for the immunolocalization of the antigens. Histologically, 61 of the goats had broncho-interstitial pneumonia, 25 had interstitial pneumonia, 42 had bronchopneumonia, 12 had bronchiolitis, and 10 were normal. PPR, PI3, and RS viral antigens were demonstrated in: intact and desquamated bronchial, bronchiolar epithelial cells, macrophages, leukocytes, pneumocytes, and giant cells. 23% of the caprine lungs had positive immuno-staining to PI3 viral antigen, 10% were positive for RSV antigen while 34% were positive for PPR viral antigen. 8% showed immunostaining for the two and or three respiratory viral antigens in the goats. PI3 and RSV antigens were more in the young goats, red sokoto breed and during the dry season. This is the first report of immunohistochemical detection of PPR, PI3 and RS viral antigens in caprine lungs in Nigeria. These findings underscore the importance of PI3 and RSV viruses in the control of caprine pneumonia in Nigeria.

  7. Bed sharing is more common in sudden infant death syndrome than in explained sudden unexpected deaths in infancy. (United States)

    Möllborg, Per; Wennergren, Göran; Almqvist, Petra; Alm, Bernt


    Despite its declining incidence, sudden infant death syndrome (SIDS) is still an important cause of death in infancy. This study investigated the environmental circumstances associated with SIDS, by analysing data from all sudden unexpected deaths in infancy (SUDI) in Sweden from 2005 to 2011. All Swedish infants forensically autopsied up to the age of 365 days from 2005 to 2011 were included. Medical records were obtained from the hospitals and supplementary data from the Swedish Medical Birth Register. Of the 261 infants, 136 were defined as SIDS and 125 as explained SUDI. The documentation in the medical records was poor when it came to issues such as bed sharing, sleep position, smoking, breastfeeding and pacifier use. The main findings were a significantly higher prevalence of bed sharing in SIDS than in explained deaths (odds ratio 7.77, 95% confidence interval 2.36-25.57) and that prone sleeping was still overrepresented. Bronchopneumonia, other infections and congenital anomalies were the most common causes of explained SUDI. Bed sharing and prone sleeping were more common in SIDS than in explained SUDI. Sparse data in medical records were a problem, and the authors are now working with the National Board of Health and Welfare on a project to establish new routines. ©2015 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

  8. Histological findings in unclassified sudden infant death, including sudden infant death syndrome. (United States)

    Liebrechts-Akkerman, Germaine; Bovée, Judith V M G; Wijnaendts, Liliane C D; Maes, Ann; Nikkels, Peter G J; de Krijger, Ronald R


    Our objective was to study histological variations and abnormalities in unclassified sudden infant death (USID), including sudden infant death syndrome (SIDS), in The Netherlands. Two hundred Dutch USID cases between 1984 and 2005 were identified. The histology slides and autopsy reports of 187 cases were available for systematic review, including brain autopsy in 135 cases. An explanation for the cause of death in 19 patients (10.2%) was found. Twelve patients had bronchopneumonia, 3 showed extensive aspiration, 2 had signs of a metabolic disorder, 1 had sepsis, and 1 had meningitis. Frequent nonspecific findings were congestion (66%), edema (47%), small hemorrhages (18%), and lymphoid aggregates (51%) in the lungs; congestion of the liver (23%); and asphyctic bleeding in the kidney (44%), adrenal gland (23%), and thymus (17%). Statistical associations were found for infection with starry sky macrophages in the thymus (P  =  0.004), with calcification (P  =  0.023), or with debris in the Hassal's corpuscles (P  =  0.034). In this study, in 10.2% of cases the histological findings were incompatible with SIDS or USID. Furthermore, several frequent nonspecific histological findings in the thymus that point toward an infection were found.

  9. Babesia (Theileria) annae in a red fox (Vulpes vulpes) from Prince Edward Island, Canada. (United States)

    Clancey, Noel; Horney, Barbara; Burton, Shelley; Birkenheuer, Adam; McBurney, Scott; Tefft, Karen


    A 4-6-mo-old female red fox (Vulpes vulpes) was presented to the Atlantic Veterinary College (AVC) Teaching Hospital, Prince Edward Island, Canada. On presentation, the fox was weak and had pale mucous membranes. A complete blood count and a serum biochemistry profile were performed. Blood smear examination revealed low numbers of erythrocytes containing centrally to paracentrally located, single, rarely multiple, approximately 1 x 2 microm, oval to round organisms with morphology similar to Babesia microti. Polymerase chain reaction testing and DNA sequencing of the Babesia species 18S rRNA gene were performed on DNA extracted from whole blood. Results were positive for a Babesia microti-like parasite genetically identical to Babesia (Theileria) annae. The fox was euthanized due to poor prognosis for recovery. Necropsy examination revealed multifocal to locally extensive subacute nonsuppurative meningoencephalitis, an eosinophilic broncho-pneumonia, a moderate diffuse vacuolar hepatopathy, and lesions associated with blunt trauma to the left abdominal region. This is the first reported case of a red fox in Canada infected with a piroplasm. It remains uncertain whether the presence of this hemoparasite in this fox was pathogenic or an incidental finding. The potential for competent vectors of Babesia species on Prince Edward Island, the potential for this Babesia microti-like parasite to infect other wild and domestic canids, and the significance of this parasite to the health of infected individuals are yet to be determined.

  10. First report of Angiostrongylus vasorum and Hepatozoon from a red fox (Vulpes vulpes) from West Virginia, USA. (United States)

    Kistler, Whitney M; Brown, Justin D; Allison, Andrew B; Nemeth, Nicole M; Yabsley, Michael J


    Angiostrongylus vasorum was identified in the lungs of a red fox (Vulpes vulpes) from West Virginia, United States (US), indicating a new geographical location for this metastrongylid nematode. The fox was euthanized and submitted for necropsy after displaying erratic behavior. We did not detect rabies virus or canine distemper virus from the fox. We observed bronchopneumonia associated with A. vasorum infection disseminated in both lungs. In addition, protozoal meronts were observed in the liver, spleen, and mesenteric lymph node, and were identified as Hepatozoon canis. Lymphoid depletion was also observed in the spleen and mesenteric lymph node. In addition to A. vasorum and H. canis infections, Eucoleus aerophilus eggs and adult worms were observed in the lungs of the fox. Severe lesions associated with A. vasorum infection were observed in the lungs and these were determined to be the likely cause of morbidity; however, synergistic effects among the multiple infections detected in this fox cannot be ruled out. This is the first report of an autochthonous A. vasorum infection in the US and from outside of Newfoundland Canada, the only place in North America where the parasite is known to be endemic. Additionally, this is the first report of a H. canis infection in a red fox from the US. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Animal models of orthopoxvirus infection. (United States)

    Chapman, J L; Nichols, D K; Martinez, M J; Raymond, J W


    Smallpox was one of the most devastating diseases known to humanity. Although smallpox was eradicated through a historically successful vaccination campaign, there is concern in the global community that either Variola virus (VARV), the causative agent of smallpox, or another species of Orthopoxvirus could be used as agents of bioterrorism. Therefore, development of countermeasures to Orthopoxvirus infection is a crucial focus in biodefense research, and these efforts rely on the use of various animal models. Smallpox typically presented as a generalized pustular rash with 30 to 40% mortality, and although smallpox-like syndromes can be induced in cynomolgus macaques with VARV, research with this virus is highly restricted; therefore, animal models with other orthopoxviruses have been investigated. Monkeypox virus causes a generalized vesiculopustular rash in rhesus and cynomolgus macaques and induces fatal systemic disease in several rodent species. Ectromelia virus has been extensively studied in mice as a model of orthopoxviral infection in its natural host. Intranasal inoculation of mice with some strains of vaccinia virus produces fatal bronchopneumonia, as does aerosol or intranasal inoculation of mice with cowpox virus. Rabbitpox virus causes pneumonia and fatal systemic infections in rabbits and can be naturally transmitted between rabbits by an aerosol route similar to that of VARV in humans. No single animal model recapitulates all known aspects of human Orthopoxvirus infections, and each model has its advantages and disadvantages. This article provides a brief review of the Orthopoxvirus diseases of humans and the key pathologic features of animal models of Orthopoxvirus infections.

  12. Intraventricular metastatic clear cell renal carcinoma. (United States)

    Sava, I; Sava, Anca; Şapte, Elena; Mihailov, Claudia; Dumitrescu, Gabriela; Poeată, I; Sava, Florina; Haba, Danisia


    Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagnosis, with an important variability of tumoral histological types in adult and pediatric population. Patient, Our case is represented by a patient, aged 48 years, without any history of significant personal pathology, accusing nausea, vomiting, and intensive headache. In the morning, he became confused, having hallucinations for a short period of time, and has accused drowsiness for several weeks. Imaging (CT and MRI) shows a neoformation in the third ventricle, accompanied by bilateral lateral ventricles dilatation, with predominantly annular enhancement. During surgery, through the middle third transcallosal interhemispheric approach, it was revealed a reddish, well-demarcated intraventricular mass, well vascularized and with a firm consistency. Final pathologic diagnosis was metastatic clear cell renal carcinoma. Initial postoperative evolution was good, and then neurological and respiratory condition worsened as a bronchopneumonia lead to patient's death in 12 days after surgery. Clear cell carcinoma metastasis located in the third ventricle should be taken into consideration for patients presenting a single intraventricular lesion even they have no documented primary malignancy.

  13. Heart transplantation in neonates and children. Intermediate-term results

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    Estela Azeka


    Full Text Available OBJECTIVE: To assess intermediate-term outcome in children who have undergone orthotopic heart transplantation. METHODS: We carried out a longitudinal and prospective study between October '92 and June '99 comprising 20 patients with ages ranging from 12 days to 7 years (mean of 2.8 years. We employed a double immunosuppression protocol with cyclosporine and azathioprine and induction therapy with polyclonal antithymocyte serum. Survival and complications resulting from the immunosuppression protocol were analyzed. RESULTS:The double immunosuppression protocol and the induction therapy with polyclonal antithymocyte serum resulted in an actuarial survival curve of 90% and 78.2% at 1 and 6 years, respectively, with a mean follow-up period of 3.6 years. One patient died due to acute rejection 40 days after transplantation; another patient died 2 years after transplantation due to lymphoproliferative disorder; a third patient died because of primary failure of the graft; and a fourth patient died due to bronchopneumonia. The major complications were as follows: acute rejection, infection, nephrotoxicity, and systemic hypertension. The means of rejection and infection episodes per patient were 2.9 and 3.4, respectively. After one year of transplantation, a slight reduction in the creatinine clearance and systemic hypertension were observed in 7 (38.9% patients. CONCLUSION: Heart transplantation made life possible for those patients with complex congenital heart diseases and cardiomyopathies in refractory congestive heart failure constituting a therapeutical option for this group of patients in the terminal phase.

  14. Ciprofloxacin plus vancomycin versus ceftazidime plus gentamicin in the treatment of pneumonia in granulocytopenic patients with or without venous catheters. Short communication. (United States)

    Krcméry, V; Fuchsberger, P; Trupl, J; Sufliarsky, J; Spanik, S; Koza, I; Kusenda, Z; Korec, S; Svec, J; Durkovic, P


    58 granulocytopenic patients with confirmed bronchopneumonia were divided retrospectively into two groups for this pilot study: group 1 included neutropenic patients with venous catheters who were treated with ciprofloxacin (CIP; 200-300 mg, i.v. b.i.d.) + vancomycin (VAN; 0.5-1 g, i.v. b.i.d.), and group 2, which included patients without venous catheters treated with ceftazidime (2 g, i.v. t.i.d.) + gentamicin (1 mg/kg, i.v. t.i.d.). Pneumonia was diagnosed clinically and radiologically in all patients; 92.3% in group 1 and 46.8% in group 2 were also microbially confirmed. Mixed infections were present in most patients. 3 of 26 patients (11.5%) in group 1 and 9 of 32 (20.1%) in group 2 did not recover while 88.5% in group 1 and 71.9% in group 2 recovered. CIP + VAN seems to be more effective in treating pneumonia in neutropenic patients, with only 1 patient in the group suffering an adverse effect compared with 5 in group 2.

  15. Sulphur Mustard Poisoning and Its Complications in Iranian Veterans

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    Beeta Balali-Mood


    Full Text Available Sulphur mustard is a chemical warfare agent, which was largelyused during the World War One and in Iraq-Iran conflict. It mayalso be used as a chemical terrorism agent. Therefore, medicalprofessions should have sufficient knowledge and be preparedfor medical intervention of any such chemical attack.Sulphur mustard exerts direct toxic effects on the eyes, skin,and respiratory tract, with subsequent systemic actions on thenervous, immunologic, hematologic, digestive, and reproductivesystems. It is an alkylating agent that affects DNA synthesis andthus, delayed complications have been considered since theWorld War One. Cases of malignancies in the target organs particularlyin hematopoietic, respiratory, and digestive systemswere reported. Common delayed respiratory complications includechronic bronchitis, bronchiectasis, frequent bronchopneumonia,and pulmonary fibrosis, all of which tend to deterioratewith time. Severe dry skin, delayed keratitis, and reduction ofnatural killer cells with subsequent increased risk of infectionsand malignancies are also among the most distressing long-termconsequences of sulphur mustard intoxication. However, despiteextensive research that has been conducted on Iranian veteransduring the past decades, major gaps continue to remain in thesulphur mustard literature. Immunological and neurological dysfunctionsand the relationship between exposure to sulphur mustardand mutagenicity, carcinogenicity, and teratogenicity areimportant fields that require further studies, particularly on Iranianveterans with chronic health problems caused by sulphurmustard poisoning. There is also a paucity of information on themedical management of acute and delayed toxic effects of sulphurmustard poisoning, a subject that greatly challenges themedical professions.

  16. Diagnostic procedures and surgical treatment of craniodorsal coxofemoral luxation in calves. (United States)

    Starke, Alexander; Herzog, Kathrin; Sohrt, Jan; Haist, Verena; Höhling, Andrea; Baumgärtner, Wolfgang; Rehage, Jürgen


    To report use of ultrasonographic examination of the coxofemoral joint, a surgical technique for repair of craniodorsal coxofemoral dislocation, and outcome. Clinical case reports. Calves (n=4) with coxofemoral luxation. Craniodorsal coxofemoral luxation was diagnosed by physical examination, radiographic, and ultrasonographic findings. Open surgical reduction of the femoral head was performed using a modified caudal approach. Craniodorsal luxation of the femoral head and the presence of an intact femoral neck were confirmed by ultrasonography. All luxations were successfully reduced and reluxation did not occur. At follow-up, 1 heifer had calved and 1 was 5 months pregnant. One calf died of bronchopneumonia 6 days after surgery. One calf had severe coxofemoral degenerative joint disease diagnosed (ultrasonography, radiography, and arthrocentesis) 3 months after surgery and confirmed by necropsy. Ultrasonography proved to be a simple and effective non-invasive technique for diagnosis of coxofemoral luxation. Immediate surgical intervention in hip dislocation in calves is necessary to avoid unnecessary trauma to subchondral structures. In calves, open instead of closed surgical reduction appears preferable because it allows access to the acetabular cavity for removal of debris. Ultrasonography should be considered a supplementary but not an alternative to radiographic examination for diagnosis of coxofemoral luxation and for follow-up examinations after reduction.

  17. Abortion and premature birth in cattle following vaccination with Brucella abortus strain RB51. (United States)

    Fluegel Dougherty, Amanda M; Cornish, Todd E; O'Toole, Donal; Boerger-Fields, Amy M; Henderson, Owen L; Mills, Ken W


    Brucella abortus RB51 is the vaccine strain currently licensed for immunizing cattle against brucellosis in the United States. Most cattle are vaccinated as heifer calves at 4-12 months of age. Adult cattle may be vaccinated in selected high-risk situations. Two herds of pregnant adult cattle in the brucellosis-endemic area of Wyoming were vaccinated with a standard label dose (1.0-3.4 × 10(10) organisms) of RB51. Reproductive losses in the vaccinated herds were 5.3% (herd A) and 0.6% (herd B) and included abortions, stillbirths, premature calves, and unbred cows (presumed early abortion). Brucella abortus was cultured from multiple tissues of aborted and premature calves (7/9), and from placenta. Isolates were identified as B. abortus strain RB51 by standard strain typing procedures and a species-specific polymerase chain reaction. Bronchopneumonia with intralesional bacteria and placentitis were observed microscopically. There was no evidence of involvement of other infectious or toxic causes of abortion. Producers, veterinarians, and laboratory staff should be alert to the risk of abortion when pregnant cattle are vaccinated with RB51, to potential human exposure, and to the importance of distinguishing field from vaccinal strains of B. abortus.

  18. Pathogens, patterns of pneumonia, and epidemiologic risk factors associated with respiratory disease in recently weaned cattle in Ireland. (United States)

    Murray, Gerard M; More, Simon J; Sammin, Dónal; Casey, Mìcheàl J; McElroy, Máire C; O'Neill, Rónan G; Byrne, William J; Earley, Bernadette; Clegg, Tracy A; Ball, Hywel; Bell, Colin J; Cassidy, Joseph P


    We examined the pathogens, morphologic patterns, and risk factors associated with bovine respiratory disease (BRD) in 136 recently weaned cattle ("weanlings"), 6-12 mo of age, that were submitted for postmortem examination to regional veterinary laboratories in Ireland. A standardized sampling protocol included routine microbiologic investigations as well as polymerase chain reaction and immunohistochemistry. Lungs with histologic lesions were categorized into 1 of 5 morphologic patterns of pneumonia. Fibrinosuppurative bronchopneumonia (49%) and interstitial pneumonia (48%) were the morphologic patterns recorded most frequently. The various morphologic patterns of pulmonary lesions suggest the involvement of variable combinations of initiating and compounding infectious agents that hindered any simple classification of the etiopathogenesis of the pneumonias. Dual infections were detected in 58% of lungs, with Mannheimia haemolytica and Histophilus somni most frequently recorded in concert. M. haemolytica (43%) was the most frequently detected respiratory pathogen; H. somni was also shown to be frequently implicated in pneumonia in this age group of cattle. Bovine parainfluenza virus 3 (BPIV-3) and Bovine respiratory syncytial virus (16% each) were the viral agents detected most frequently. Potential respiratory pathogens (particularly Pasteurella multocida, BPIV-3, and H. somni) were frequently detected (64%) in lungs that had neither gross nor histologic pulmonary lesions, raising questions regarding their role in the pathogenesis of BRD. The breadth of respiratory pathogens detected in bovine lungs by various detection methods highlights the diagnostic value of parallel analyses in respiratory disease postmortem investigation.

  19. Molecular survey of infectious agents associated with bovine respiratory disease in a beef cattle feedlot in southern Brazil. (United States)

    Headley, Selwyn A; Okano, Werner; Balbo, Luciana C; Marcasso, Rogério A; Oliveira, Thalita E; Alfieri, Alice F; Negri Filho, Luiz C; Michelazzo, Mariana Z; Rodrigues, Silvio C; Baptista, Anderson L; Saut, João Paulo E; Alfieri, Amauri A


    We investigated the occurrence of infectious pathogens during an outbreak of bovine respiratory disease (BRD) in a beef cattle feedlot in southern Brazil that has a high risk of developing BRD. Nasopharyngeal swabs were randomly collected from steers ( n = 23) and assessed for the presence of infectious agents of BRD by PCR and/or RT-PCR assays. These included: Histophilus somni, Mannheimia haemolytica, Pasteurella multocida, Mycoplasma bovis, bovine respiratory syncytial virus (BRSV), bovine coronavirus (BCoV), bovine viral diarrhea virus (BVDV), bovine alphaherpesvirus 1 (BoHV-1), and bovine parainfluenza virus 3 (BPIV-3). Pulmonary sections of one steer that died with clinical BRD were submitted for pathology and molecular testing. The frequencies of the pathogens identified from the nasopharyngeal swabs were: H. somni 39% (9 of 23), BRSV 35% (8 of 23), BCoV 22% (5 of 23), and M. haemolytica 13% (3 of 23). PCR or RT-PCR assays did not identify P. multocida, M. bovis, BoHV-1, BVDV, or BPIV-3 from the nasopharyngeal swabs. Single and concomitant associations of infectious agents of BRD were identified. Fibrinous bronchopneumonia was diagnosed in one steer that died; samples were positive for H. somni and M. haemolytica by PCR. H. somni, BRSV, and BCoV are important disease pathogens of BRD in feedlot cattle in Brazil, but H. somni and BCoV are probably under-reported.


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    I G A P Eka Pratiwi


    Full Text Available Eventration of diaphragm (ED refers to an abnormally high position of part or all of the diaphragm, but intact diaphragm, usually associated with a marked decrease in muscle fibers and a membranous appearance of the abnormal area with only the peripheral thoracic attachments showing normal muscle. Etiologically ED is congenital or acquired. Congenital diaphragmatic abnormalities occur in 1 per 2000 to 4000 birth, which 7% is diaphragmatic eventration. Most children with ED are asymptomatic when incidentally first seen, will not need theraphy. Those with symptoms develop acute respiratory distress, feeding difficulties, and recurrent pneumonitis. If the patient need assissted ventilation or cannot be weaned off the ventilator, she or he should be plicated. Failure to achieve extubation within a week of plication is an ominous prognostic sign. We reported a case of one month and four days old girl who was dispnea, feeding difficulty and bronchopneumonia caused by right ED with acquired etiology. Plication was done to repaired the symptom. But unfortunately this was not succeded because there was complication of postoperative treatment.

  1. Zygotic Porcn paternal allele deletion in mice to model human focal dermal hypoplasia.

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    Steffen Biechele

    Full Text Available In mouse and humans, the X-chromosomal Porcupine homolog (Porcn gene is required for the acylation and secretion of all 19 Wnt ligands, thus representing a bottleneck in the secretion of Wnt ligands. In humans, mutations in PORCN cause the X-linked dominant syndrome Focal Dermal Hypoplasia (FDH, OMIM#305600. This disorder is characterized by ecto-mesodermal dysplasias and shows a highly variable phenotype, potentially due to individual X chromosome inactivation patterns. To improve the understanding of human FDH, we have established a mouse model by generation of Porcn heterozygous animals carrying a zygotic deletion of the paternal allele. We show that heterozygous female fetuses display variable defects that do not significantly affect survival in the uterus, but lead to perinatal lethality in more than 95% of females. Rare survivors develop to adulthood and display variable skeletal and skin defects, representing an adult zygotic mouse model for human FDH. Although not frequently reported in humans, we also observed bronchopneumonia, rhinitis, and otitis media in these animals, suggesting a potential link between Porcn function and the normal development of ciliated cells in these tissues.

  2. [Evaluation of the treatment with levodropropizine of respiratory diseases in children]. (United States)

    Fiocchi, A; Zuccotti, G V; Vignati, B; Pogliani, L; Sala, M; Riva, E


    Sometimes, antitussives can be a valid adjuvant to respiratory tract infections treatment. Although not always needed, this therapeutic support can be extremely useful in selected cases, and when patient is resident and monitored. In this line, the efficacy of a new peripheral antitussive, levodropropizine (Dompé farmaceutici, Milan), has been evaluated in 70 children inpatients of the Pediatric Department at san Paolo Hospital - Milan University - from September 1987 to May 1988. Thirty one male and 29 female children, aged 4 years and 6 months +/- 3 years and 5 months, suffering from various respiratory tract diseases were included in the study. Underlying diseases were represented by 21 acute bronchitis, 20 asthmatic attacks, 18 bronchopneumonia, 11 tracheitis, 6 acute episodes of chronic bronchitis, 2 hypoglottis laryngitis, 1 pertussis, 1 spontaneous pneumothorax. All parents gave their oral informed consent. The basic treatments were antibiotics in 44 patients associated or not with beta 2 agonists (31), theophylline (15), corticosteroids via aerosol (9) or parenterally (3), immunomodulators (2). Treatment with levodropropizine in the oral drops formulation at 2 mg pro kg a day was continued for 5 days and withdrawn according to the clinical evolution. Cough was registered by means of appropriate record forms given to the parents as well as with 120' tape recording whenever possible, i.e. 60 minutes before and 60 minutes after drug administration, on day one and 2. At treatment end, parents and investigator gave an antitussive efficacy judgement. Tolerability was evaluated as per clinical evolution and laboratory parameters.

  3. Ground-glass opacity in diffuse lung diseases: high-resolution computed tomography-pathology correlation; Opacidades em vidro fosco nas doencas pulmonares difusas: correlacao da tomografia computadorizada de alta resolucao com a anatomopatologia

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    Santos, Maria Lucia de Oliveira; Vianna, Alberto Domingues; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Souza Junior, Arthur Soares [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Disciplina de Radiologia; Moraes, Heleno Pinto de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Patologia]. E-mail:


    Ground-glass opacity is a finding frequently seen in high-resolution computed tomography examinations of the chest and is characterized by hazy increased attenuation of lung, however without blurring of bronchial and vascular margins. Due to its un specificity, association with other radiological, clinical and pathological findings must be considered for an accurate diagnostic interpretation. In this paper were reviewed 62 computed tomography examinations of patients with diffuse pulmonary diseases of 14 different etiologies in which ground-glass opacity was the only or the most remarkable finding, and correlated this findings with pathology abnormalities seen on specimens obtained from biopsies or necropsies. In pneumocystosis, ground-glass opacities correlated histologically with alveolar occupation by a foaming material containing parasites, in bronchiole alveolar cell carcinoma with thickening of the alveolar septa and occupation of the lumen by mucus and tumoral cells, in paracoccidioidomycosis with thickening of the alveolar septa, areas of fibrosis and alveolar bronchopneumonia exudate, in sarcoidosis with fibrosis or clustering of granulomas and in idiopathic pulmonary fibrosis with alveolar septa thickening due to fibrosis. Alveolar occupation by blood was found in cases of leptospirosis, idiopathic hemo siderosis, metastatic kidney tumor and invasive aspergillosis whereas oily vacuole were seen in lipoid pneumonia, proteinaceous and lipo proteinaceous material in silico proteinosis and pulmonary alveolar proteinosis, and edematous fluid in cardiac failure. (author)

  4. Mycoplasma pneumoniae pneumonia: CT features in 16 patients

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    Lee, Inho; Kim, Tae Sung; Yoon, Hye-Kyung [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea)


    The objective of this study was to assess the computed tomography (CT) features of Mycoplasma pneumoniae pneumonia. We retrospectively reviewed CT findings of 16 patients (M:F=9:7, age range 1-74 years, median 9 years) with serologically proven Mycoplasma pneumoniae pneumonia and with chest CT scan available. Two distinctive patterns of CT features of M. pneumoniae pneumonia were noted between the paediatric (age <18 years) and the adult (age {>=}18 years) groups. The pediatric group (n=11) showed lobar or segmental consolidation (100%) with frequent pleural effusion (82%) and regional lymphadenopathy (82%) and mild volume decrease of the involved lobe (73%), while four of the five adult patients showed diffuse and/or multifocal, centrilobular or peribronchovascular areas of ground-glass attenuation (80%) with a lobular distribution, and frequent thickening of interlobular septa (60%) and the bronchial walls (40%) were also detected at high-resolution CT. The CT finding of a lobar or segmental consolidation with a parapneumonic effusion seen in our children with M. pneumoniae pneumonia was similar to that of bacterial lobar pneumonia. In contrast, the CT findings noted in our adult patients consisted of a mixture of a bacterial bronchopneumonia pattern and a viral interstitial pneumonia pattern. (orig.)

  5. Radiologic and clinical findings of mycoplasma pneumonia in children

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    Choi, Yong Jin; Oh, Ki Keun [College of Medicine, Yonsei University, Seoul (Korea, Republic of)


    Mycoplasma Pneumonia is a cause of primary atypical pneumonia, but it is asymptomatic mostly or may cause of only mild symptoms. School-aged children experienced high attack rate and manifestation if 'unusual pneumonia' are noted. So authors reviewed clinical and radiological features of 110 cases of serologically proven Mycoplasma pneumonia in hospitalized children between November 1984 and January 1987 retrospectively. The results were as follows ; 1. The sex distribution was 57:53 (1.1:1) in male to female ratio and 47% of them were 5 though 8 years old of age with peak incidence between 5 and 6 years old of age. 2. The symptoms were cough, fever, and sore throat in descending order of frequency and mean symptom duration before admission was 8.1 day. The prevalent season was earlier winter. 3. The radiologic findings were air-space consolidation with lobar, segmental distribution in 68%, interstitial infiltration in 12%, bronchopneumonia in 12%, chronic bronchitis pattern in 3.6%, normal in 4.5%, hilar LN enlargement in 37%, pleural effusion in 12%. 4. Radiologic resolution period was usually 10 days around (4-25 days) and after complete recovery, scarring change or calcification was not seen. 5. Extrapulmonary manifestations were uncommon but hepatitis, hematuria, skin rash, gastroenteritis, myocarditis, otitis media occurred. 6. With administration of tetracyclin and erythromycin, clinical and radiologic responses were promptly seen.

  6. Profile of foreign body ingestion and outcomes of endoscopic management in pediatric population

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    Avinash Bhat Balekuduru


    Full Text Available Background: Foreign body (FB ingestion is a frequent gastrointestinal emergency in pediatric population. Improvement in endoscopic techniques and equipment enables nonsurgical management in most situations. Recent data from India on pediatric FB ingestion have been lacking. Aim: The aim of this study was to assess the profile and outcome after endoscopic management of patients <18 years of age presenting with FB ingestion. Patients and Methods: Records of all the children with FB ingestion who had undergone endoscopic removal at our institution during 5 years (2011–2016 were assessed retrospectively. The nature of FB ingested, and success and complication of endoscopic therapy were analyzed. Results: There were 150 pediatric endoscopies during the study period. Of this, 120 (80% were for removal of ingested FB. Most common (MC FB was coin (69%. The retrieved FBs were 83 coins, 13 batteries, 5 pins, 4 clips, 2 each of anklets, keys, marbles, and seeds, one each of spoon, blade, spanner, peanut, toe ring, and a pencil. One had trichobezoar. Esophagus was the MC site of location of FB (85/120. FB removal was successful by flexible endoscopy in 97.1%. Four (0.03% cases were referred for rigid endoscopic/surgical removal by otolaryngologists/pediatric surgeon. Except for one child developed bronchopneumonia, there was no morbidity or mortality in the study. Conclusion: Endoscopic removal of FB is a safe procedure with excellent outcomes in a specialized gastroenterology unit.

  7. Pleuritis and suppurative pneumonia associated with a hypermucoviscosity phenotype of Klebsiella pneumoniae in California sea lions (Zalophus californianus). (United States)

    Jang, Spencer; Wheeler, Liz; Carey, Roberta B; Jensen, Bette; Crandall, Claudia M; Schrader, Kimmi N; Jessup, David; Colegrove, Kathleen; Gulland, Frances M D


    The aim of this study is to document the isolation of a hypermucoviscosity (HMV) phenotype of Klebsiella pneumoniae from 25 cases of suppurative pneumonia and pleuritis and two cases of abscesses in California sea lions (Zalophus californianus) from the central California coast, representing the first report of this zoonotic pathogen from the marine environment and only the second report in non-humans. Animals died 2h to 4 days after first being observed sick on beaches. Clinical signs varied from dyspnoea to coma. Gross post-mortem examination of 25 cases revealed fibrinous pleuritis, copious pus in the pleural cavity and suppurative bronchopneumonia. K. pneumoniae isolates obtained from lung and pleural swabs and the hepatic and subcuticular abscesses were highly mucoid on blood agar culture media and were positive to the "string test". Twenty-one of the 27 isolates were examined by PCR and all were positive for rmpA and K2wyz and negative for K1magA genes. Although pneumonia and pleuritis have previously commonly been observed in marine mammals, their association with pure cultures of a zoonotic bacteria, K. pneumoniae HMV phenotype, has not. This report provides further evidence of the role marine mammals play as sentinels of health risks to humans from coastal waters. Copyright 2009 Elsevier B.V. All rights reserved.

  8. Burden of respiratory tract infections at post mortem in Zambian children. (United States)

    Bates, Matthew; Shibemba, Aaron; Mudenda, Victor; Chimoga, Charles; Tembo, John; Kabwe, Mwila; Chilufya, Moses; Hoelscher, Michael; Maeurer, Markus; Sinyangwe, Sylvester; Mwaba, Peter; Kapata, Nathan; Zumla, Alimuddin


    Autopsy studies are the gold standard for determining cause-of-death and can inform on improved diagnostic strategies and algorithms to improve patient care. We conducted a cross-sectional observational autopsy study to describe the burden of respiratory tract infections in inpatient children who died at the University Teaching Hospital in Lusaka, Zambia. Gross pathology was recorded and lung tissue was analysed by histopathology and molecular diagnostics. Recruitment bias was estimated by comparing recruited and non-recruited cases. Of 121 children autopsied, 64 % were male, median age was 19 months (IQR, 12-45 months). HIV status was available for 97 children, of whom 34 % were HIV infected. Lung pathology was observed in 92 % of cases. Bacterial bronchopneumonia was the most common pathology (50 %) undiagnosed ante-mortem in 69 % of cases. Other pathologies included interstitial pneumonitis (17 %), tuberculosis (TB; 8 %), cytomegalovirus pneumonia (7 %) and pneumocystis Jirovecii pneumonia (5 %). Comorbidity between lung pathology and other communicable and non-communicable diseases was observed in 80 % of cases. Lung tissue from 70 % of TB cases was positive for Mycobacterium tuberculosis by molecular diagnostic tests. A total of 80 % of TB cases were comorbid with malnutrition and only 10 % of TB cases were on anti-TB therapy when they died. More proactive testing for bacterial pneumonia and TB in paediatric inpatient settings is needed.

  9. Evolution of patients with oropharyngeal dysphasia in hospital environment

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    Jurkiewicz, Ari Leon


    Full Text Available Introduction: Neurogenic etiology oropharyngeal dysphagia may lead to clinical malnutrition, laryngotracheal damage, and result in aspirative bronchopneumonia. This condition is present in the evaluations routine of the phonoaudiologist who works in hospitals with post CVA (cerebral vascular accident patients. Objective: The objective of this study is to evaluate the evolution of neurogenic oropharyngeal dysphagia patients after CVA, during interment period until hospital discharge, and to analyze the dysphagia degree before treatment; diagnostic tools; phonoaudiologic routines; state o the patients upon discharge. Method: Thirty-nine (39 patients were studied from December 2003 through June 2004 complaining of deglutition disorder, that indicates dysphagia. A standardized protocol was prepared for collection of clinical data. Conclusion: The results allowed to conclude that there was moderate degree dysphagia, followed of light and severe degrees; in the instrumental diagnosis there was a prevalence of laryngeal aspiration, followed of a change in the oropharyngeal phase, laryngeal penetration, change in the deglutition oral phase; in the phonoaudiological procedures, the food manipulation presented excellent results followed of postural and protective maneuvers; upon hospital discharge there was a prevalence of individuals who had a good level clinical state and were eating orally with some postural and/or food consistency modifications without the use of probe, followed by those who presented a regular level beginning the oral diet with the use of probe, but able to be discharged between 30 to 60 days after the hospital period.

  10. Characteristics of patients hospitalized at an intensive care unit due to drug abuse

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    Flávia Antunes


    Full Text Available Objective. To characterize the clinical and demographic profile of patients hospitalized due to drug intoxication at an intensive care unit (ICU of a teaching hospital between 2004 and 2010. Methodology. In this descriptive study, information was collected from the hospitalized patients, as informed by a Toxicology Care Center (CAT in Paraná (Brazil. The clinical files were checked and information was collected about age, gender, toxic agents and intoxication circumstances, comorbidities and clinical outcomes. Results. Sixty-two patients were included in the study, with a mean age of 58 years and 77% male. Alcohol was the substance related to most hospitalizations (77%, followed by psychoactive drugs (14% and marihuana and crack (5% each. The main comorbidities were bronchopneumonia due to aspiration (37%, alcohol-related liver cirrhosis (24% and traumatic brain injury (19%. The most frequent intoxication circumstances were chronic abuse (79%, attemptive suicide (19% and acute abuse (4.9%. Thirty-nine percent of the patients died during hospitalization. Conclusion. The results show a concerning reality, as most of the patients are men of economically active age, who were intoxicated by a legal substance like alcohol, with a relevant number of deaths. Nurses need to pay particular attention to this health problem, in the context of which they play a fundamental role as educators with a view to the encouragement of healthy lifestyles.

  11. Limitations in the approach health caregivers can take in end-of-life care decisions. (United States)

    Bülbül, S; Sürücü, M; Karavaizoğlu, C; Eke, M


    In the terminal stages of neuro-metabolic diseases, parents can begin to experience a sense of loss even before the child dies, and might accept death prematurely. A 2.5-year-old female patient with Sandoff Disease (diagnosed at 9 months of age), and a 17-month-old male Krabbe patient (diagnosed at 5 months of age) were admitted to the hospital with hypernatraemic dehydration and bronchopneumonia, respectively, within 10 days of each other. Both patients developed respiratory arrest short after admission and were supported with mechanical ventilation. Both families gave written consent to end life support, but their wishes could not be accepted according to Turkish law. Specialists are expected to communicate well with families and give continuous care while respecting the opinions of patients' families on the timing of the withdrawal of life support. However, ethical and legal regulations on the conduct of health care professionals in these circumstances are unclear in Turkey and should be developed rapidly. © 2014 John Wiley & Sons Ltd.

  12. Pyoderma Gangrenosum: A Rare Cause of Cutaneous Ulceration and One Easily Misdiagnosed

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    Wedad Abdelrahman


    Full Text Available Pyoderma gangrenosum (PG is a rare inflammatory neutrophilic dermatosis often misdiagnosed. It is uncommon in infants and children accounting for 4% of cases. A one-year-old male in paediatric ICU ventilated for bronchopneumonia was referred with ulcerated areas on his neck and axilla corresponding to sites of recent removal of central and arterial lines. Examination revealed areas of deep ulceration with violaceous undermined borders in keeping with PG. This was supported by a skin biopsy showing a neutrophilic infiltrate in the deeper dermis. Topical clobetasol propionate was commenced and a dramatic improvement within 24 hours noted. Blood results showed a leucocytosis of 29.7; a differential WCC showed toxic granulation in neutrophils with myeloid left shift; immunoglobulins showed elevated IgG 23 and IgA 4.86. The elevated WCC made us consider a leukaemic trigger; however, they settled with treatment of the underlying infection. PG in children is more likely to have an atypical distribution involving the head and neck (26.6% or buttocks (15%. An interesting feature in this case is the presence of pathergy, a term used to describe the induction or exacerbation of PG at sites of iatrogenic or incidental trauma. It is seen in 31% of patients with PG.

  13. Vibrio parahaemolyticus- and V. alginolyticus-associated meningo-encephalitis in a bottlenose dolphin (Tursiops truncatus) from the Adriatic coast of Italy. (United States)

    Di Renzo, Ludovica; Di Francesco, Gabriella; Profico, Chiara; Di Francesco, Cristina E; Ferri, Nicola; Averaimo, Daniela; Di Guardo, Giovanni


    A case of Vibrio parahaemolyticus- and V. alginolyticus-associated meningo-encephalitis in a bottlenose dolphin (Tursiops truncatus) found stranded along the Adriatic coast of Italy in 2016 is herein reported, along with a minireview on V. parahaemolyticus and V. alginolyticus infections in aquatic mammals. Macroscopically, two abscesses were found in the dolphin's forebrain, along with an extensive, bilateral, parasitic broncho-pneumonia. Histologically, a suppurative-to-pyogranulomatous meningo-encephalitis involved the brain but not the cerebellum. Microbiological investigations yielded isolation of V. parahaemolyticus and V. alginolyticus from the aforementioned abscesses and from the brain parenchyma, respectively, with simultaneous recovery of Shewanella algae from the heart and of Photobacterium damselae from a blowhole swab. Although V. parahaemolyticus and V. alginolyticus, which are widely distributed across marine ecosystems worldwide, likely played a role in the development of the suppurative meningo-encephalitis in this dolphin, we are not aware of previous isolations of any of these two bacteria neither from cetacean brain lesions, nor from abscesses in aquatic mammals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Emergency endovascular treatment of emergent or ruptured aortic aneurysms: A single centre experience

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    England, Andrew [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom)]. E-mail:; Butterfield, John S. [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); Nasim, Akhtar [Department of Vascular Surgery, South Manchester University Hospitals, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); Welch, Mark [Department of Vascular Surgery, South Manchester University Hospitals, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); McCollum, Charles N. [Department of Vascular Surgery, South Manchester University Hospitals, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); Ashleigh, Raymond J. [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom)


    Objective: To report our experience with emergency endovascular repair (eEVAR) in patients with ruptured or acutely symptomatic AA. Methods: From August 1998 to June 2004, 22 high-risk patients (21 men, median age 74 years, range 15-84 years) with ruptured or acutely symptomatic aneurysms underwent eEVAR using Talent endoprostheses. All procedures were performed in the operating theatre by a surgical/radiology team. Indications for repair, co-morbidities and outcomes were recorded with follow-up by US and CT scanning. Results: Of 22 eEVARs, 13 patients had abdominal AA and nine patients had thoracic AA. Nineteen (86.4%) repairs were technically successful, there was one patient with a type I proximal endoleak treated conservatively and two patients died during their inpatient period (myocardial infarction and broncho-pneumonia). On follow-up of the 20 survivors (median 7 months, range 0-48 months), there were three further deaths, and two further endoleaks. The 1-year survival by life-table analysis is 75 {+-} 9.8% and 13 patients are free from reintervention at last follow-up. Conclusion: eEVAR had encouraging initial results in selected high-risk patients.

  15. Experimental Infection of New Zealand White Rabbits (Oryctolagus cuniculi) with Leporid herpesvirus 4 (United States)

    Sunohara-Neilson, Janet R; Brash, Marina; Carman, Susy; Nagy, Éva; Turner, Patricia V


    Leporid herpesvirus 4 (LHV4) is a novel alphaherpesvirus recently identified in domestic rabbits (Oryctolagus cuniculi). Little is known about the pathogenesis or time course of disease induced by this virus. We therefore intranasally inoculated 22 female New Zealand white rabbits with 8.4 × 104 CCID50 of a clinical viral isolate. Rabbits were monitored for clinical signs, viral shedding in oculonasal secretions, and development and persistence of serum antibodies. Rabbits were euthanized at 3, 5, 7, 14, and 22 d postinfection (dpi) to evaluate gross and microscopic changes. Clinical signs were apparent between 3 to 8 dpi, and included oculonasal discharge, respiratory distress, and reduced appetite, and viral shedding occurred between 2 and 8 dpi. Seroconversion was seen at 11 dpi and persisted to the end of the study (day 22). Severe necrohemorrhagic bronchopneumonia and marked pulmonary edema were noted by 5 dpi and were most severe at 7 dpi. Pulmonary changes largely resolved by 22 dpi. In addition, multifocal splenic necrosis was present at 5 dpi and progressed to submassive necrosis by 7 dpi. Eosinophilic herpesviral intranuclear inclusion bodies were detected in the nasal mucosa, skin, spleen, and lung between 3 to 14 dpi. LHV4 is a pathogen that should be considered for rabbits that present with acute respiratory disease. LHV4 infection can be diagnosed based on characteristic microscopic changes in the lungs and spleen and by virus isolation. Serum antibody levels may be used to monitor viral prevalence in colonies. PMID:24210019

  16. In Vitro Potential of Equine DEFA1 and eCATH1 as Alternative Antimicrobial Drugs in Rhodococcosis Treatment (United States)

    Jung, Sascha; Bruhn, Oliver; Goux, Didier; Leippe, Matthias; Leclercq, Roland; Laugier, Claire; Grötzinger, Joachim; Cauchard, Julien


    Rhodococcus equi, the causal agent of rhodococcosis, is a severe pathogen of foals but also of immunodeficient humans, causing bronchopneumonia. The pathogen is often found together with Klebsiella pneumoniae or Streptococcus zooepidemicus in foals. Of great concern is the fact that some R. equi strains are already resistant to commonly used antibiotics. In the present study, we evaluated the in vitro potential of two equine antimicrobial peptides (AMPs), eCATH1 and DEFA1, as new drugs against R. equi and its associated pathogens. The peptides led to growth inhibition and death of R. equi and S. zooepidemicus at low micromolar concentrations. Moreover, eCATH1 was able to inhibit growth of K. pneumoniae. Both peptides caused rapid disruption of the R. equi membrane, leading to cell lysis. Interestingly, eCATH1 had a synergic effect together with rifampin. Furthermore, eCATH1 was not cytotoxic against mammalian cells at bacteriolytic concentrations and maintained its high killing activity even at physiological salt concentrations. Our data suggest that equine AMPs, especially eCATH1, may be promising candidates for alternative drugs to control R. equi in mono- and coinfections. PMID:22232283

  17. Influence of hypoxia in bronchial response to bronchoconstrictor substances at newborn with distress respiratory syndrome (DRS). (United States)

    Bozalija, Adnan; Islami, Pëllumb; Gashi, Njazi; Maloku, Halit; Shabani, Ragip; Bexheti, Sadi; Islami, Hilmi


    In this work, role of hypoxia in respiratory system on live and exited newborns weight 250-3000g.) which have died due to different reasons is studied. Response of tracheal rings in acetylcholine and histamine in different molar concentrations (10(-4), 10(-3), 10(-2), 10(-1) mol/dm3) was monitored. Study of the tracheal smooth musculature (TSM) tonus was performed in 12 tracheal preparations obtained from the newborns exited due to different reasons. Based on the functional analysis of the isolated tracheal preparations, we have concluded that the cases born with lung atelectasis have caused significant response ofTSM to Acetylcholine and Histamine (p > 0.01). In cases of control group, which has exited due to different reasons from lung inflammatory processes (e.g.: pneumonia, bronchopneumonia, cerebral hemorrhage), Acetylcholine and Histamine have also caused significant constriction of tracheal smooth musculature. Results suggest that exited cases with lung atelectasis (hypoxemia) and cases of lung inflammatory processes have significant constrictor action to Acetylcholine and Histamine in tracheobronchial system.

  18. Congenital Hyperferritinemia Diagnosed in A 2 Month Old-A Case Report from India. (United States)

    Lodh, Moushumi; Kerketta, Joshi Anand


    In clinical medicine, ferritin is predominantly utilized as a serum marker of total body iron stores. In cases of iron deficiency and overload, serum ferritin serves a critical role in both diagnosis and management. Elevated serum and tissue ferritin are linked to coronary artery disease, malignancy, and poor outcomes following stem cell transplantation. Ferritin is directly implicated in less common but potentially devastating human diseases including sideroblastic anemias, neurodegenerative disorders, and hemophagocytic syndrome. We report a case of congenital hyperferritinemia with serum iron within reference range, along with bronchopneumonia, acyanotic congenital heart disease, anemia, hypocalcaemia and dysmorphism in a 2 month old baby. Symptomatic treatment was given. The baby was discharged after 7 days. In a stable condition and having gained some weight.He was diagnosed as a case of congenital hyperferritinemia as C reactive protein levels normalized but ferritin levels remained high and A37C mutation within the iron-responsive element of L-ferritin was detected. He was born to consanguineous parents, there was history of cataract in the family and his mother also had high serum ferritin levels. This case is an example of the detection of a rare genetic disorder in a child admitted with apparently innocuous symptoms of fever and inflammation. Our case underlines the importance of monitoring ferritin levels, along with other signs of inflammation in order to differentiate congenital hyperferritinemia from inflammatory cause.

  19. Gingipains: Critical Factors in the Development of Aspiration Pneumonia Caused by Porphyromonas gingivalis. (United States)

    Benedyk, Małgorzata; Mydel, Piotr Mateusz; Delaleu, Nicolas; Płaza, Karolina; Gawron, Katarzyna; Milewska, Aleksandra; Maresz, Katarzyna; Koziel, Joanna; Pyrc, Krzysztof; Potempa, Jan


    Aspiration pneumonia is a life-threatening infectious disease often caused by oral anaerobic and periodontal pathogens such as Porphyromonas gingivalis. This organism produces proteolytic enzymes, known as gingipains, which manipulate innate immune responses and promote chronic inflammation. Here, we challenged mice with P. gingivalis W83 and examined the role of gingipains in bronchopneumonia, lung abscess formation, and inflammatory responses. Although gingipains were not required for P. gingivalis colonization and survival in the lungs, they were essential for manifestation of clinical symptoms and infection-related mortality. Pathologies caused by wild-type (WT) P. gingivalis W83, including hemorrhage, necrosis, and neutrophil infiltration, were absent from lungs infected with gingipain-null isogenic strains or WT bacteria preincubated with gingipain-specific inhibitors. Damage to lung tissue correlated with systemic inflammatory responses, as manifested by elevated levels of TNF, IL-6, IL-17, and C-reactive protein. These effects were unequivocally dependent on gingipain activity. Gingipain activity was also implicated in the observed increase in IL-17 in lung tissues. Furthermore, gingipains increased platelet counts in the blood and activated platelets in the lungs. Arginine-specific gingipains made a greater contribution to P. gingivalis-related morbidity and mortality than lysine-specific gingipains. Thus, inhibition of gingipain may be a useful adjunct treatment for P. gingivalis-mediated aspiration pneumonia. © 2015 S. Karger AG, Basel.

  20. Immunohistochemical study of porcine lung lesions associated with Pasteurella multocida. (United States)

    Pors, Susanne E; Hansen, Mette S; Bisgaard, Magne; Jensen, Henrik E; Iburg, Tine M


    Infectious bronchopneumonia is a widespread disease in modern commercial pig production and Pasteurella multocida is frequently associated with the lesions. To evaluate porcine lung lesions associated with P. multocida, populations of inflammatory cells were examined by immunohistochemistry in necrotic lung lesions from nine pigs and exudative lung lesions from eleven pigs. Lungs from five pigs served as controls. All cases were selected from naturally infected pigs using co-infection based criteria to make them as comparable as possible. The inflammatory cells demonstrated by immunohistochemistry were T-lymphocytes (CD3(+), CD4(+) and CD8(+) subsets), B-lymphocytes, neutrophils, macrophages, and IgA(+), IgM(+) and IgG(+) cells. The results showed that (1) a significant increase in all inflammatory cells was found in lesions associated with P. multocida, (2) necrotic lesions had a larger number of CD3(+) T-lymphocytes and IgA(+) cells, and (3) cases with exudative lesions had a more CD8(+) T-lymphocytes, B-lymphocytes, macrophages and neutrophils. No differences in the numbers of CD4(+) T-lymphocytes, IgG(+) and IgM(+) positive cells were found between necrotic and exudative cases. The results show that P. multocida significantly alters the inflammatory response in the lung and that lesions associated with P. multocida display diverse inflammatory responses according to their distinct morphological pattern. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. The origin of Pasteurella multocida impacts pathology and inflammation when assessed in a mouse model. (United States)

    Pors, Susanne E; Chadfield, Mark S; Sørensen, Dorte B; Offenberg, Hanne; Bisgaard, Magne; Jensen, Henrik E


    Host-pathogen interactions of Pasteurella multocida isolates of different origin were studied in a mouse model, focusing on pathology, bacterial load and expression of the metalloproteinase MMP9 and its inhibitor TIMP1. Intranasal inoculation with one of three doses (10(6), 10(4), 10(2)CFU) of an isolate from porcine pneumonia or fowl cholera showed marked differences between the two isolates. The avian isolate was highly pathogenic with severe signs of necrotizing pneumonia, liver necrosis and high bacterial load in lung and liver. Clinical signs and pathology related to the porcine isolate were dose dependent and consisted of exudative bronchopneumonia, abscess formation in liver and a lower bacterial load in lung and liver. Both isolates caused increased expression of MMP9 and TIMP1. In conclusion, evaluation and comparison of pathogenicity and host-pathogen interaction of P. multocida isolates from different hosts is possible in the intranasal murine model. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Pasteurella multocida and bovine respiratory disease. (United States)

    Dabo, S M; Taylor, J D; Confer, A W


    Pasteurella multocida is a pathogenic Gram-negative bacterium that has been classified into three subspecies, five capsular serogroups and 16 serotypes. P. multocida serogroup A isolates are bovine nasopharyngeal commensals, bovine pathogens and common isolates from bovine respiratory disease (BRD), both enzootic calf pneumonia of young dairy calves and shipping fever of weaned, stressed beef cattle. P. multocida A:3 is the most common serotype isolated from BRD, and these isolates have limited heterogeneity based on outer membrane protein (OMP) profiles and ribotyping. Development of P. multocida-induced pneumonia is associated with environmental and stress factors such as shipping, co-mingling, and overcrowding as well as concurrent or predisposing viral or bacterial infections. Lung lesions consist of an acute to subacute bronchopneumonia that may or may not have an associated pleuritis. Numerous virulence or potential virulence factors have been described for bovine respiratory isolates including adherence and colonization factors, iron-regulated and acquisition proteins, extracellular enzymes such as neuraminidase, lipopolysaccharide, polysaccharide capsule and a variety of OMPs. Immunity of cattle against respiratory pasteurellosis is poorly understood; however, high serum antibodies to OMPs appear to be important for enhancing resistance to the bacterium. Currently available P. multocida vaccines for use in cattle are predominately traditional bacterins and a live streptomycin-dependent mutant. The field efficacy of these vaccines is not well documented in the literature.

  3. Mortality study for a decade: ischemic stroke in the elderly.

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    Javier J. García Zacarías


    Full Text Available Cerebrovascular diseases are among the top three causes of death in Cuba and the world, about 80 % of these patients belong to Ischemic Stroke. The objective of this paper is to describe the clinical and developmental profile of patients who died of Ischemic Stroke. A descriptive, prospective research, cross- sectional study was made, the sample included all deaths from ischemic stroke at the University Hospital "Camilo Cienfuegos" Sancti Spiritus, between January 1st, 2001 and December 31, 2010, and persons over 60 years of age with necropsy performed. Atherothrombotic stroke was the most frequent category, the highest mortality rates were observed in persons over 80 years of age and in females, hypertension, ischemic heart disease and transient ischemic attack were the main significant medical history; most patients were admitted in the stroke unit and died in Middle Progressive Care, cerebral edema and intracranial hypertension and hypostatic bronchopne umonia were complications and specific main causes of most frequent death. Value of cerebral edema and hypostatic bronchopneumonia as clinical complications and causes of death in patients investigated is confirmed.

  4. Spontaneous and Dosing Route-related Lung Lesions in Beagle Dogs from Oral Gavage and Inhalation Toxicity Studies: Differentiation from Compound-induced Lesions. (United States)

    Mukaratirwa, Sydney; Garcia, Begonya; Isobe, Kaori; Petterino, Claudio; Bradley, Alys


    This study was conducted to characterize lung microscopic lesions in control beagle dogs from inhalation and oral gavage toxicity studies, to determine differences associated with the route of administration, and to discuss distinguishing features from compound-induced lung lesions. Samples from 138 control dogs from oral gavage studies and 124 control dogs from inhalation (vehicle control) studies were evaluated microscopically. There was no significant sex-related difference in the incidence of all lesions. Perivascular mononuclear cell infiltration, centriacinar mixed cell infiltration, bronchopneumonia, subpleural septal fibrosis, and alveolar macrophage accumulation were the most common lesions. Aspiration pneumonia was more common in dogs from gavage studies, suggesting reflux after gavage dosing or accidental administration of test formulation as possible causes. Centriacinar mixed cell infiltration was more common in dogs from inhalation studies, suggesting mild irritation by the vehicles used. Vascular lesions, which included pulmonary arteriopathy and smooth muscle mineralization, were observed in a few animals. Some of the spontaneous lesions are similar to lesions induced by test compounds. Compared to spontaneous lesions, compound-induced lesions tend to be multifocal or diffuse, follow a pattern of distribution (e.g., centriacinar, perivascular, and interstitial), show a dose response in the incidence and severity, and may show cell-specific toxicity. © The Author(s) 2016.

  5. Two different avipoxviruses associated with pox disease in Magellanic penguins (Spheniscus magellanicus) along the Brazilian coast. (United States)

    Niemeyer, Claudia; Favero, Cíntia M; Kolesnikovas, Cristiane K M; Bhering, Renata C C; Brandão, Paulo; Catão-Dias, José Luiz


    A novel avipoxvirus caused diphtheritic lesions in the oesophagus of five and in the bronchioli of four Magellanic penguins (Spheniscus magellanicus) and also cutaneous lesions in eight Magellanic penguins housed in outdoor enclosures in a Rehabilitation Centre at Florianópolis, Santa Catarina State, Brazil. At the same time, another avipoxvirus strain caused cutaneous lesions in three Magellanic penguins at a geographically distinct Rehabilitation Centre localized at Vila Velha, Espírito Santo State, Brazil. Diagnosis was based on clinical signs, histopathology and use of the polymerase chain reaction (PCR). Clinical signs in the penguins included cutaneous papules and nodules around eyelids and beaks, depression and restriction in weight gain. The most common gross lesions were severely congested and haemorrhagic lungs, splenomegaly and cardiomegaly. Histological examination revealed Bollinger inclusion bodies in cutaneous lesions, mild to severe bronchopneumonia, moderate periportal lymphocytic hepatitis, splenic lymphopenia and lymphocytolysis. Other frequent findings included necrotizing splenitis, enteritis, oesophagitis, dermatitis and airsacculitis. Cytoplasmic inclusion bodies were seen within oesophageal epithelial cells in five birds and in epithelial cells of the bronchioli in four penguins. DNA from all samples was amplified from skin tissue by PCR using P4b-targeting primers already described in the literature for avipoxvirus. The sequences showed two different virus strains belonging to the genus Avipoxvirus of the Chordopoxvirinae subfamily, one being divergent from the penguinpox and avipoxviruses already described in Magellanic penguins in Patagonia, but segregating within a clade of canarypox-like viruses implicated in diphtheritic and respiratory disease.

  6. Spontaneous Lung Lesions in Aging Laboratory Rabbits ( Oryctolagus cuniculus). (United States)

    Cooper, T K; Griffith, J W; Chroneos, Z C; Izer, J M; Willing, L B; Peng, X


    Spontaneous age-related lesions of laboratory rabbits are not well documented in the contemporary scientific literature. A retrospective study of diagnostic necropsies of 36 rabbits >2 years of age found a number of common lung lesions. Fibromuscular intimal hyperplasia affected medium and to a lesser extent large pulmonary arteries and was present to a variable extent in all 36 rabbits >2 years of age. The lesions were characterized by fragmentation and/or reduplication of the internal elastic lamina (IEL), proliferation of smoothelin+/alpha-smooth muscle actin (α-SMA)+/vimentin- smooth muscle cells and fewer smoothelin-/α-SMA+/vimentin+ myofibroblasts, and intimal deposition of collagen without thrombosis, embolism, or evidence of pulmonary hypertension. Pulmonary emphysema, present in 30/36 rabbits, was characterized by the loss of alveolar septa; most affected rabbits did not have clinical signs of respiratory disease. In 8/13 rabbits of the inbred EIII/JC audiogenic strain, we identified a unique syndrome of granulomatous pneumonia containing hyaline brown to gray, globular to ring-like acellular material that was Alcian blue and periodic acid-Schiff positive. The material was immunoreactive for surfactant protein-A and had the ultrastructural appearance of multilamellar vesicles, suggesting a genetic defect in surfactant metabolism. Additionally, we found small benign primary lung tumors (fibropapillomas, 5 rabbits) not previously described. Other findings included heterotopic bone (5 rabbits), subacute to chronic suppurative bronchopneumonia, pyogranulomatous pneumonia with plant material, and pulmonary artifacts from barbiturate euthanasia solution.

  7. Nocardiosis in a Kidney-Pancreas Transplant

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    I. Fontana


    Full Text Available 34-year-old man with chronic renal and pancreas failure in complicated diabetic disease received a kidney-pancreas transplantation. On the 32nd postoperative day, an acute kidney rejection occurred and resolved with OKT3 therapy. The patient also presented refractory urinary infection by E. Fecalis and M. Morganii, and a focal bronchopneumonia in the right-basal lobe resolved with elective chemotherapy. During the 50th post-operative day, an intense soft tissue inflammation localized in the first left metatarsal-phalangeal articulation occurred (Figure 1 followed by an abscess with a cutaneous fistula and extension to the almost totality of foot area. The radiological exam revealed a small osteo-lacunar image localized in the proximal phalanx head of the first finger foot. From the cultural examination of the purulent material, N. Asteroides was identified. An amoxicillin-based treatment was started and continued for three months, with the complete resolution of infection This case is reported for its rarity in our casuistry, and for its difficult differential diagnosis with other potentially serious infections.

  8. August 2012 imaging case of the month

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    Gotway MB


    Full Text Available No abstract available. Article truncated at 150 words. Clinical History: A 48-year-old non-smoking man presented with a history of slowly progressive shortness of breath and recent onset of a headache. Frontal chest radiography (Figure 1 was performed.Figure 1: Frontal chest radiography shows normal cardiomediastinal contours with bilateral peri- and infrahilar predominant ground-glass opacity with a background of linear and reticular abnormalities.Which of the differential diagnostic considerations listed below is the most likely consideration for the chest radiographic abnormality?1.Pneumococcal pneumonia 2.Lung carcinoma3.Idiopathic pulmonary fibrosis4.Pulmonary alveolar proteinosis5.Miliary tuberculosisCorrect!Answer: 4. Pulmonary alveolar proteinosisThe frontal chest radiograph shows bilateral increased lung attenuation consisting of ground-glass opacity and a background of linear and reticular abnormalities. Pneumococcal pneumonia is a possibility, but this infection most commonly presents either with an air-space pneumonia pattern [homogeneous lung opacity with air bronchograms extending towards the pleural surface] or with a bronchopneumonia pattern [patchy …

  9. Pleurodesis Induction in Rats by Copaiba (Copaifera multijuga Hayne Oil

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    Fernando Luiz Westphal


    Full Text Available This study aims to assess and compare copaiba oleoresin of Copaifera multijuga and 0.5% silver nitrate for the induction of pleurodesis in an experimental model. Ninety-six male Wistar rats were divided into three groups: control (0.9% saline solution, copaiba (copaiba oil, and silver nitrate (0.5% silver nitrate. The substances were injected into the right pleural cavity and the alterations were observed macroscopically and microscopically at 24, 48, 72, and 504 h. The value of macroscopic alterations grade and acute inflammatory reaction grade means was higher in the 24 h copaiba group in relation to silver nitrate. Fibrosis and neovascularization means in the visceral pleura were higher in 504 h copaiba group in relation to the silver nitrate group. The grade of the alveolar edema mean was higher in the silver nitrate group in relation to the copaiba group, in which this alteration was not observed. The presence of bronchopneumonia was higher in the 24 h silver nitrate group (n = 4 in relation to the copaiba group (n = 0. In conclusion, both groups promoted pleurodesis, with better results in copaiba group and the silver nitrate group presented greater aggression to the pulmonary parenchyma.

  10. [Treatment and rehabilitation of dysphagia following cerebrovascular disease]. (United States)

    López-Liria, Remedios; Fernández-Alonso, Melodie; Vega-Ramírez, Francisco A; Salido-Campos, M Ángeles; Padilla-Góngora, David


    INTRODUCTION. Bronchopneumonia is a frequent complication in the first days after a cerebrovascular disease and is linked with a higher rate of mortality. It occurs in patients with an altered level of consciousness or tussigenic reflex, and could be prevented with an early dysphagia rehabilitation programme. AIMS. To review the scientific literature on the treatment and rehabilitation of patients with dysphagia after suffering a stroke, published between 2002 and 2012. DEVELOPMENT. A search conducted in the PubMed, Cochrane, PEDro, CINAHL and ENFISPO databases yielded 15 papers that fulfilled eligibility criteria and the initial aims of the study, providing information about 3,212 patients. The different protocols and techniques for re-education in dysphagia are described and include compensatory strategies, orofacial regulation therapy, music therapy, sensory stimulation, lip muscle, tongue, pharynx, larynx and respiratory tract training, Mendelsohn manoeuvre, neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation and acupuncture. CONCLUSIONS. The studies examined in this research claim that the treatment of dysphagia following a stroke can improve the function of deglutition (coordination, speed, volume), quality of life and people's social relationships. Further work needs to be carried out to establish or define what kind of therapies, techniques, exercises or manoeuvres are the most effective in dysphagia. Generally agreed treatment or rehabilitation protocols also need to be drawn up within units that address stroke in an integrated manner.

  11. Radiographic, computed tomographic, and ultrasonographic findings with migrating intrathoracic grass awns in dogs and cats. (United States)

    Schultz, Ryan M; Zwingenberger, Allison


    The purpose of this study was to describe the clinical, radiographic, and computed tomographic findings in dogs and cats with migrating intrathoracic grass awns. Thirty-five dogs and five cats with visual confirmation of a grass awn following surgery, endoscopy or necropsy, and histology were assessed. The medical records and all diagnostic imaging studies were reviewed retrospectively. Labrador Retrievers or English Pointers leukogram of which 14 had a left shift or toxic neutrophils. Radiographs were performed in 38 animals and computed tomography (CT) in 14. Thoracic radiographs were characterized by focal pulmonary interstitial to alveolar opacities (n = 26) that occurred most commonly in the caudal (n = 19) or accessory lobes (n = 8). Additional findings included pneumothorax (n = 9), pleural effusion (n = 8), and pleural thickening (n = 7). Pulmonary opacities identified on radiographs correlated to areas of pneumonia and foreign body location. CT findings included focal interstitial to alveolar pulmonary opacities (n = 12) most commonly in the right caudal lung lobe (n = 9), pleural thickening (n = 11), mildly enlarged intrathoracic lymph nodes (n = 10), soft tissue tracking (n = 7) with enhancing margins (n = 4), pneumothorax (n = 6), pleural effusion (n = 4), and foreign body visualization (n = 4). Histologic diagnoses included pulmonary and mediastinal granulomas or abscesses, bronchopneumonia, and pleuritis. Migrating intrathoracic grass awns should be considered as a differential diagnosis in coughing, febrile animals with focal interstitial to alveolar pulmonary opacities, pleural effusion, pleural thickening, and/or pneumothorax on radiographs or CT.

  12. Mortalidad extrahospitalaria en menores de 1 año

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    Felipa E. García García


    Full Text Available Se presenta un estudio retrospectivo de 40 niños menores de 1 año, fallecidos fuera de un centro hospitalario en el período comprendido de enero de 1989 a diciembre de 1990 en Ciudad de La Habana. La muerte natural apareció con mayor frecuencia y dentro de ella las bronconeumonías, cardiopatías y sepsis fueron las 3 primeras causas. El maltrato se presentó en el 40 % de los casos, y se comportó el intencional y la muerte por negligencia de igual forma con el 50 % respectivamente. No se identificó la muerte súbita, aunque sí se hallaron aspectos relacionados con ella, como la edad al morir, sexo y horario de defunciones.It is presented a retrospective study of 40 children under one year old, who died outside a hospital center from January, 1989 to December, 1990, in Havana City. Natural death was the most frequent, and within it bronchopneumonias, cardiopathies, and sepsis were the first three causes. Mistreatment was present in 40 % of the cases; whereas intentional mistreatment and death due to negligence behaved in the same way with 50 %, respectively. Sudden death was not identified, although some aspects connected with it such as age of death, sex, and time of decesse were found.

  13. Cerebellar peduncle abscess secondary to disseminated strangles in a six-week-old miniature foal

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    Brianne Henderson


    Full Text Available During a strangles outbreak within a herd of minature horses, a six week old foal developed acute onset clinical signs of sepsis and neurological deficits. The foal was euthanized and submitted for post-mortem at the Animal Health Laboratories, Guelph Ontario. Gross post-mortem examination noted severe bronchopneumonia, hypopyon of the right eye and a singular cerebellar peduncle abscess. Culture of the lungs and cerebellum produced a pure growth of Streptococcus equi ssp. equi. Streptococcus equi ssp. equi, the causative agent of equine strangles, produces an acute pyrexia, purulent lymphadenopathy of submandibular and retropharyngeal lymph nodes. Commonly, lymph node abscesses rupture and resolve without complication. Rarely, complications may include: dissemination of the bacteria with diffuse abscess formation, immune mediated disease (purpura haemorrhagica, rarely abscess formation within the central nervous system (CNS can occur. These can be managed medically with appropriate antibiotics and drugs to reduce intra-cranial pressure, however surgical drainage and debulking of the abscess has been attempted successfully in a few cases.

  14. The Pathology of Experimental Rhoodococcus equi infection in foals

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    Karima Al-Salihi


    Full Text Available The pathology of experimental Rhodococcus equi (R. equi infection in 2-8 weeks-old-foal is studied. For this purpose, twenty foals were divided into three groups, and given R. equi intratracheally (1st group, through gastric route (2nd group and through umbilicus by contamination (3rd group. A control group of foals were given a Phosphate buffered Saline (PBS. Pulmonary and intestinal lesions were seen in foals of all infected groups. Grossly, there were multiple, variable-sized abscesses diffusely scattered throughout the lung parenchyma, in addition to the presence of different stages of pneumonia with variable-sized areas of consolidation and emphysema. Intestinal lesions were evident as engorgement of mesenteric blood vessels, subserosal hemorrhages seen along the intestinal tract especially the small intestine, in addition to enlargement of lymph nodes (mesenteric, bronchial and mediastinal. Some lymph nodes were edematous, have circular foci of caseous necrosis and some of them were filled with yellowish, thick creamy pus. The microscopic lesions were basically similar in all foals of the experimental groups, but varied depending on the time of death or euthanasia and included: acute pulmonary congestion, acute suppurative broncho-pneumonia, chronic pyogranulomatous pneumonia, and emphysematous and atelectatic area. There were focal necrosis of the pulmonary parenchyma and numerous bacterial colonies seen free or as aggregates within the cytoplasm of many histiocytes. Also, there were focal interstitial thickening of the alveolar septae. The pleura and interlobular septae were thickened due to cellular infiltration.

  15. Clinical characteristics and computed tomography findings of pulmonary toxoplasmosis after hematopoietic stem cell transplantation. (United States)

    Sumi, Masahiko; Norose, Kazumi; Hikosaka, Kenji; Kaiume, Hiroko; Takeda, Wataru; Kirihara, Takehiko; Kurihara, Taro; Sato, Keijiro; Ueki, Toshimitsu; Hiroshima, Yuki; Kuraishi, Hiroshi; Watanabe, Masahide; Kobayashi, Hikaru


    The prognosis of pulmonary toxoplasmosis, including disseminated toxoplasmosis involving the lungs, following hematopoietic stem cell transplantation (HSCT) is extremely poor due to the difficulties associated with early diagnosis and the rapidly progressive deterioration of multiorgan function. In our institution, we identified nine cases of toxoplasmosis, representing incidences of 2.2 and 19.6 % among all HSCT recipients and seropositive HSCT recipients, respectively. Of the patients with toxoplasmosis, six had pulmonary toxoplasmosis. Chest computed tomography (CT) findings revealed centrilobular, patchy ground-glass opacities (n = 3), diffuse ground-glass opacities (n = 2), ground-glass opacities with septal thickening (n = 1), and marked pleural effusion (n = 1). All cases died, except for one with suspected pulmonary toxoplasmosis who was diagnosed by a polymerase chain reaction assay 2 days after the onset of symptoms. In pulmonary toxoplasmosis, CT findings are non-specific and may mimic pulmonary congestion, atypical pneumonia, viral pneumonitis, and bronchopneumonia. Early diagnosis and treatment is crucial for overcoming this serious infectious complication. Pulmonary toxoplasmosis should be considered during differential diagnosis in a recipient with otherwise unexplained signs of infection and CT findings with ground-glass opacities, regardless of the distribution.

  16. Neumonías, reporte de dos casos tratados por homeopatía*

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    Jorge Luis Campistrous Lavaut


    Full Text Available Las neumonías son entidades que afectan al aparato respiratorio, especialmente al pulmón. Su tratamiento habitual es el uso de antibióticos y en ocasiones en cantidades abusivas. En el presente trabajo se describen dos casos que fueron tratados por homeopatía y en los cuales no fue necesario el uso de los antibióticos. Ambas pacientes habían padecido de bronconeumonía en 3 ocasiones anteriores. A las 2 pacientes se les indicó tratamiento con Phosphoro 6 CH durante 1 mes consecutivo a razón de 5 gotas 3 veces al día, y su respuesta fue favorable al tratamiento, al concluir éste se le dio el medicamento de fondo. Hace 6 meses que padecieron la neumonía y se mantienen asintomáticas.Pneumonias are diseases affecting the respiratory system, specially the lungs. Its habitual treatment consists in the use of antibiotics, which are sometimes excessively used. In this paper we describe 2 cases that are treated by homeopathy with no need of antibiotics. Both patients had suffered from bronchopneumonia 3 times before. They were treated with 5 drops of Phosphorus 6 CH 3 times a day during a month and the response was favorable. On concluding the treatment, they continued taking drugs. These subjects suffered from pneumonia 6 months ago and they are still asymptomatic.

  17. 'Recurrent lower respiratory tract infections' - going around in circles, respiratory medicine style. (United States)

    Everard, Mark L


    Recurrent lower respiratory tract infections are very common in childhood, particularly the pre-school years. The term lower respiratory tract infection [LTRI] is, as with many terms used in respiratory medicine, used very loosely and carries little more information than the often decried term 'chest infections'. LRTIs should more accurately be characterised by the type of infection [viral or bacterial], the site of infection [conducting airways, or respiratory compartment or both - bronchitis/pneumonia/bronchopneumonia], the nature of the episode [acute or acute on chronic (exacerbation)], the interaction with co-morbidities such as asthma. The limited nature of the responses of the lower airways to any insult whether it is infective or irritation due to inhaled or aspirated chemicals means that almost any aetiology can lead to cough, shortness of breath and noisy breathing. We lack good non-invasive techniques to study the nature of the inflammation in the lower airways and hence the cause of chronic and recurrent symptoms in patients is frequently mis-diagnosed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Respiratory syncytial virus infection of the lower respiratory tract: radiological findings in 108 children

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    Kern, S.; Uhl, M. [Dept. of Diagnostic Radiology, University Hospital Freiburg (Germany); Berner, R.; Schwoerer, T. [Dept. of Pediatrics, University Hospital Freiburg (Germany); Langer, M. [Dept. of Diagnostic Radiology, University Hospital Freiburg (Germany)


    For years the typical appearance of respiratory syncytial virus (RSV)-induced infection of the lower respiratory tract has been discussed. All available studies have led to different results. The aim of this study was to control these results, with 108 children. The age range was 1 day to 10 years (median 7 months). Within 72 h of admission, all children developed an RSV infection of the lower respiratory tract. Chest X-rays (pa-view) of 55 children under, and 53 children over, the age of 6 months (10/53>24 months) were evaluated. The diagnosis of RSV and the chest X-ray were mostly done on the same day. The major radiological findings of the two age-groups were compared by Wilcoxon's unpaired rank sum test. Major radiological findings were: normal chest X-ray (30%), central pneumonia (32%) or peribronchitis (26%). There was no statistical significance between the age-groups. Other findings were emphysema (11%), pleural effusion (6%), lobar- or broncho-pneumonia (each 6%), atelectasis (5%) or pneumothorax in one case. Therefore, the most common radiological findings in RSV-induced infection of the lower respiratory tract, supported by our results (RSV infection without bacterial superinfection) are central pneumonia, peribronchitis or normal chest X-ray. Thus an age-group separation into under or over 6 months is no longer necessary. (orig.)

  19. Age-related thoracic radiographic changes in golden and labrador retriever muscular dystrophy. (United States)

    Bedu, Anne-Sophie; Labruyère, Julien J; Thibaud, Jean Laurent; Barthélémy, Inès; Leperlier, Dimitri; Saunders, Jimmy H; Blot, Stéphane


    Golden retriever and Labrador retriever muscular dystrophy are inherited progressive degenerative myopathies that are used as models of Duchenne muscular dystrophy in man. Thoracic lesions were reported to be the most consistent radiographic finding in golden retriever dogs in a study where radiographs were performed at a single-time point. Muscular dystrophy worsens clinically over time and longitudinal studies in dogs are lacking. Thus our goal was to describe the thoracic abnormalities of golden retriever and Labrador retriever dogs, to determine the timing of first expression and their evolution with time. To this purpose, we retrospectively reviewed 390 monthly radiographic studies of 38 golden retrievers and six Labrador retrievers with muscular dystrophy. The same thoracic lesions were found in both golden and Labrador retrievers. They included, in decreasing frequency, flattened and/or scalloped diaphragmatic shape (43/44), pulmonary hyperinflation (34/44), hiatal hernia (34/44), cranial pectus excavatum (23/44), bronchopneumonia (22/44), and megaesophagus (14/44). The last three lesions were not reported in a previous radiographic study in golden retriever dogs. In all but two dogs the thoracic changes were detected between 4 and 10 months and were persistent or worsened over time. Clinically, muscular dystrophy should be included in the differential diagnosis of dogs with a combination of these thoracic radiographic findings. © 2012 Veterinary Radiology & Ultrasound.

  20. A case of kwashiorkor in a child with congenital hypothyroidism

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    Helena Aneke Tangkilisan


    Full Text Available A 12-year-old Indonesian girl with the body weight of 9.8 kg and length 78 cm was admitted to the Department of Child Health, Manado General Hospital with kwashiorkor and congenital hypothyroidism. The main complaint was edema starting 3 weeks before admission. Physical examination showed body weight for age (BW/A 14.3%, body weight for body length (BW/BL 66.0% and body length for age (BL/A 49.1%. On admission she looked severely ill, apathetic, with hypothermia and hypotonia. Almost all signs and symptoms of kwashiorkor and congenital hypothyroidism were found accompanied bronchopneumonia and dermatologic problems. Laboratory findings showed severe anemia, leukocytosis, hypoproteinemia, hyponatremia, hypokalemia, elevated thyroid stimulating hormone and low level of Thyroxine-4. Bone age equaled to a newborn baby bone age. There was no thyroid tissue on thyroid ultrasound examination. The patient was treated for severe protein energy malnutrition and ThyraxR. Problems of kwashiorkor could been solved well but not with the congenital hypothyroidism. She was discharged from hospital after 2 months treatment and till now at 14th year of age with her developmental milestones equals to that of 8 month old baby.

  1. Aerosol infection of calves with Histophilus somni. (United States)

    Jánosi, Katalin; Stipkovits, László; Glávits, Róbert; Molnár, Tamás; Makrai, László; Gyuranecz, Miklós; Varga, János; Fodor, László


    The purpose of this study was to develop and evaluate an aerosol infection method with Histophilus somni that closely resembles the natural way of infection of calves. Another aim was to compare the virulence of two H. somni strains by collecting clinical and postmortem data of experimentally infected and control animals. Seventeen conventionally reared 3-month-old calves were divided into three groups. Two groups of six animals each were exposed to suspensions containing H. somni on three consecutive days using a vaporiser mask. The third group of five animals was used as control. The data of individual clinical examination were recorded daily. All animals were exterminated, and gross pathology of all lungs was evaluated on the 15th day after the first infection. Both H. somni strains caused an increase of rectal temperature, respiratory signs, decrease of weight gain, and severe catarrhal bronchopneumonia in both infected groups. Although some chronic lesions were detected in the lungs of the control animals as well, the histopathological findings in the infected and control groups were different. H. somni was recultured from all lungs in the challenged groups but it could not be reisolated or detected by PCR examination in the control group. This is the first paper on aerosol challenge of calves with H. somni using repeated infection and verified by detailed pathological, bacteriological and histopathological examination. The infection method proved to be successful. There was no difference in the virulence of the two H. somni strains used in the trial.

  2. Histo- and immunopathological features of terminal AIDS. An autopsy case of a Japanese man with neurological signs as initial symptoms. (United States)

    Miyayama, H; Takeya, M; Takahashi, K; Koito, A; Hattori, T; Takatsuki, K


    An autopsy case of a 37-year-old Japanese man, confirmed as an AIDS patient infected by an undetermined route of transmission, is presented. The initial symptoms of full-blown AIDS in this case were neurological, and the patient died of severe pneumonia 9 months after onset. The main histo- and immunopathological features were a marked depletion of helper-inducer T cells and dendritic reticulum cells in the lymphoid tissues, opportunistic infections, and some neuropathologic changes. Very few cells, possibly macrophages, immunoreactive with a monoclonal antibody (VAK-5) against HIV-gag protein P24 were found in the mediastinal lymph nodes. Numerous pathogens had induced opportunistic infections in many organs: severe and generalized cytomegalovirus infection, Pneumocystis carinii pneumonia, bronchopneumonia (possibly due to Pseudomonas aeruginosa), candidiasis in the tongue and oral cavity, and atypical mycobacteriosis in the pulmonic hilar lymph nodes. Vascular proliferation was found in the perinodal regions of some lymph nodes, but this was not neoplastic vascular proliferation compatible with that of localized Kaposi's sarcoma.

  3. Conjunctivitis, tracheitis, and pneumonia associated with herpesvirus infection in green sea turtles. (United States)

    Jacobson, E R; Gaskin, J M; Roelke, M; Greiner, E C; Allen, J


    Fourteen juvenile (15- to 20-month-old) green sea turtles (Chelonia mydas), representative of a group of sea turtles with clinical signs of respiratory tract disease, were euthanatized and submitted for necropsy. Macroscopically, lesions included periglottal necrosis, tracheitis with intraluminal caseous and laminated necrotic debris, and severe pneumonia. Several turtles had caseous conjunctival exudate covering the eyes. Microscopically, the turtles had fibrinonecrotic inflammation around the glottal opening, tracheitis, and severe bronchopneumonia and interstitial pneumonia. In multifocal areas, periglottal and tracheal epithelial cells adjacent to areas of necrosis had hypertrophic nuclei with amphophilic intranuclear inclusions. A mixed population of primarily gram-negative microorganisms was isolated from the tracheal and glottal lesions. Attempts at viral isolation in cultures of green sea turtle kidney cells resulted in the development of cytopathic effects characterized by giant cell formation and development of intranuclear inclusions. Using electron microscopy, intranuclear viral particles (88 to 99 nm in diameter) were seen in inclusion-containing tracheal and glottal epithelial cells and infected green sea turtle kidney cells; particles were consistently seen enveloping from nuclear membranes, and mature particles (132 to 147 nm) were found in the cytoplasm. On the basis of size, conformation, location, and presence of an envelope, the particles most closely resembled those of herpes-viruses.


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    Ramakrishna Rachakonda


    Full Text Available BACKGROUND Patients attending the Pulmonology OPD with symptoms of cough with expectoration of more than 10 days with pulmonary shadows suggestive of pneumonia were included in our study. Patients’ positive for AFB in the sputum and symptoms suggestive of tuberculosis were excluded. MATERIALS AND METHODS 156 patients diagnosed to have pneumonia were included in the study. Patients having a history of cough with expectoration and fever for 10 days or more were subjected to clinical, radiological and sputum examination. Patients in whom tuberculosis was excluded by clinical, radiological and sputum examination and having associated shadows in the chest x-ray above 20 years of age were taken into the study and subjected to thorough clinical examination, haematological and biochemical examination. Sputum was sent for Gram stain and culture and sensitivity. Sensitivity pattern of the organisms isolated were studied. RESULTS 85% of patients belong to 40 years and above age group. 73.12% of these patients are males and rest are females. 54% of the patients presented as bronchopneumonia by Radiology. Bilateral lesions present in 55% of patients followed by right-sided lesions in 26% and left-sided lesions in 19%. Cough, expectoration, fever and chest pain were the common symptoms and nearly all the patients had symptoms. Increased white cell count at the time of admission correlated with increased duration of hospital stay and is statistically significant (the p-value is <0.00001. Active and passive smoking is associated with pneumonia and the value is statistically significant (p<0.00001. Presence of comorbidities is associated with increased hospital stay and the value is statistically significant (p<0.00001. Individual comorbidities are not associated with increased prevalence of pneumonia. Presence of comorbidities compared to absence of comorbidities showed a statistically significant correlation (p value <0.00001. 48% of the patients were

  5. Ocorrência de pneumonia associada à infecção por Mannheimia haemolytica em ovinos de Minas Gerais Occurrence of pneumonia associated to infection by Mannheimia haemolytica in sheep of Minas Gerais

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    Marina Rios de Araújo


    animals were not medicated and found dead. Grossly, the pulmonary findings were similar in all sheep. The pulmonary cranial lobes and the ventral portion of caudal lobes were consolidated and purulent exsudate streamed out of the airways. In the parenchyma of the cranial lobes there were white slightly prominent multifocal to coalescent areas with 0.2 to 0.5cm in diameter intercalated with dark red areas. Consolidated lesions occupied 70 to 80% of the lungs. Fibrinous pleuritis was observed in sheep 1, 2 and 3. Microscopically, the findings were fibrinopurulent bronchopneumonia with intense hyperemia, areas with intra-alveolar hemorrhage and thickening of interlobular septa with numerous neutrophils, cellular rests and scattering fibrin. Multifocal areas with liquefaction necrosis containing numerous bacterial colonies were observed in sheep 1, 2 and 3. In the cranial lobes of these sheep, there were areas with degenerated neutrophils forming clusters of basophilic cells with alongated nuclei ("oat cells" associated with bacterial colonies. The histological findings were characteristic of pneumonia caused by Mannheimia (M. haemolytica. Samples of the cranial lobes were sent for bacterial culture, and M. haemolytica was isolated and identified in all animals. This is the first report correlating pathological findings and the isolation of M. haemolytica as cause of bronchopneumonia in sheep in the country.

  6. PCR assay detects Mannheimia haemolytica in culture-negative pneumonic lung tissues of bighorn sheep (Ovis canadensis) from outbreaks in the western USA, 2009-2010. (United States)

    Shanthalingam, Sudarvili; Goldy, Andrea; Bavananthasivam, Jegarubee; Subramaniam, Renuka; Batra, Sai Arun; Kugadas, Abirami; Raghavan, Bindu; Dassanayake, Rohana P; Jennings-Gaines, Jessica E; Killion, Halcyon J; Edwards, William H; Ramsey, Jennifer M; Anderson, Neil J; Wolff, Peregrine L; Mansfield, Kristin; Bruning, Darren; Srikumaran, Subramaniam


    Mannheimia haemolytica consistently causes severe bronchopneumonia and rapid death of bighorn sheep (Ovis canadensis) under experimental conditions. However, Bibersteinia trehalosi and Pasteurella multocida have been isolated from pneumonic bighorn lung tissues more frequently than M. haemolytica by culture-based methods. We hypothesized that assays more sensitive than culture would detect M. haemolytica in pneumonic lung tissues more accurately. Therefore, our first objective was to develop a PCR assay specific for M. haemolytica and use it to determine if this organism was present in the pneumonic lungs of bighorns during the 2009-2010 outbreaks in Montana, Nevada, and Washington, USA. Mannheimia haemolytica was detected by the species-specific PCR assay in 77% of archived pneumonic lung tissues that were negative by culture. Leukotoxin-negative M. haemolytica does not cause fatal pneumonia in bighorns. Therefore, our second objective was to determine if the leukotoxin gene was also present in the lung tissues as a means of determining the leukotoxicity of M. haemolytica that were present in the lungs. The leukotoxin-specific PCR assay detected leukotoxin gene in 91% of lung tissues that were negative for M. haemolytica by culture. Mycoplasma ovipneumoniae, an organism associated with bighorn pneumonia, was detected in 65% of pneumonic bighorn lung tissues by PCR or culture. A PCR assessment of distribution of these pathogens in the nasopharynx of healthy bighorns from populations that did not experience an all-age die-off in the past 20 yr revealed that M. ovipneumoniae was present in 31% of the animals whereas leukotoxin-positive M. haemolytica was present in only 4%. Taken together, these results indicate that culture-based methods are not reliable for detection of M. haemolytica and that leukotoxin-positive M. haemolytica was a predominant etiologic agent of the pneumonia outbreaks of 2009-2010.

  7. The influence of detoxification agents on the intensity of side effects caused by medium-high doses of methotrexate in children with acute lymphoblastic leukemia: Case series

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    Šumar Jovana S.


    Full Text Available Objective The treatment of childhood acute lymphoblastic leukemia (ALL in Serbia is conducted according to protocol ALL IC BMF-2009. The therapy includes the application of cytostatic drugs methotrexate and 6-mercaptopurine, and drug detoxifying Calcium Folinate. At the moment, 80% of affected children could be cured with current treatment, but resistance to the therapy and its toxic effects remain serious clinical problems. The aim of the study was to investigate the influence of detoxification agents (Calcium Folinate, silymarin and ursodeoxycholic acid on the side effects of methotrexate, applied in this protocol. Methods A modified acute toxicity form (GPOH was used for side effects monitoring. The research included children with either standard or intermediate risk ALL in the consolidation therapy phase, who were hospitalised at the Institute for Child and Youth Health Care of Vojvodina in Novi Sad during the period from July 2010 to February 2011. Results The most frequent side effect after 40 applications of methotrexate in ten children was bone marrow depression. Methotrexate caused: leukopenia in 10 patients, thrombocytopenia in 5 patients; after the use of folic acid, platelet count grew in 8 patients, leukocyte in 2 patients. Less frequent side effects: an increase serum transaminase activity, the state of fever, bronchopneumonia, diarrhoea with mild cramps and hypercalcaemia. Conclusion The application of Calcium Folinate, silymarin and ursodeoxycholic acid prevented the occurrence of severe adverse effects caused by medium-high doses of methotrexate. Observed adverse effects were of mild to moderate intensity, reversible and did not significantly disturb the quality of life in treated patients.

  8. Coexistence of mixed phenotype Creutzfeldt-Jakob disease, Lewy body disease and argyrophilic grain disease plus histological features of possible Alzheimer's disease: a multi-protein disorder in an autopsy case. (United States)

    Fernández-Vega, Iván; Ruiz-Ojeda, Javier; Juste, Ramon A; Geijo, Maria; Zarranz, Juan Jose; Sánchez Menoyo, Jose Luis; Vicente-Etxenausia, Ikerne; Mediavilla-García, Jennifer; Guerra-Merino, Isabel


    We report hereby an autopsy case of sporadic mixed phenotype CJD without hereditary burden and a long-term clinical course. An 80-year old man was diagnosed with mild cognitive impairment 27 months before death, caused by bronchopneumonia and severe respiratory impairment. During this time, the patient developed gradual mental deterioration, some sleeping problems and myoclonus. Other clinical manifestations were progressive gait problems, language deterioration, presence of primitive reflexes and irritability. In keeping with those symptoms, a rapidly evolving dementia was clinically suspected. Cerebrospinal fluid test for 14-3-3 protein was negative. However, an abnormal EEG and MRI at end-stage of disease were finally consistent with CJD. Post-mortem examination revealed a massive cortical neuronal loss with associated reactive astrocytosis, also evident in the white matter. Diffuse spongiform changes involving some basal ganglia, especially medial thalamus, some troncoencephalic nuclei, mainly inferior olivary nucleus and the molecular layer of the cerebellum were seen. Immunorreactive deposits for anti-prion protein antibody were present at different areas of the CNS. Additionally, Lewy bodies were observed at the brainstem and amygdala. Furthermore, argirophilic grains together with oligodendroglial coiled bodies and pre-tangle inclusions in the neurons from the limbic system containing hyperphosphorylated 4R tau were noted. To the best of our knowledge, this is the first case of CJD combined with Lewy body disease and argirophilic grain disease. Furthermore, we believe this case is an extremely rare combination of MM2-cortical-type and MM2-thalamic-type sporadic CJD (sCJD), which explains the broad spectrum of MM2-type sCJD findings and symptoms. Moreover, histological features of possible Alzheimer's disease were also reported. © 2014 Japanese Society of Neuropathology.

  9. Fatal canine distemper infection in a pack of African wild dogs in the Serengeti ecosystem, Tanzania. (United States)

    Goller, Katja V; Fyumagwa, Robert D; Nikolin, Veljko; East, Marion L; Kilewo, Morris; Speck, Stephanie; Müller, Thomas; Matzke, Martina; Wibbelt, Gudrun


    In 2007, disease related mortality occurred in one African wild dog (Lycaon pictus) pack close to the north-eastern boundary of the Serengeti National Park, Tanzania. Histopathological examination of tissues from six animals revealed that the main pathologic changes comprised interstitial pneumonia and suppurative to necrotizing bronchopneumonia. Respiratory epithelial cells contained numerous eosinophilic intracytoplasmic inclusion bodies and multiple syncytial cells were found throughout the parenchymal tissue, both reacting clearly positive with antibodies against canine distemper virus (CDV) antigen. Phylogenetic analysis based on a 388 nucleotide (nt) fragment of the CDV phosphoprotein (P) gene revealed that the pack was infected with a CDV variant most closely related to Tanzanian variants, including those obtained in 1994 during a CDV epidemic in the Serengeti National Park and from captive African wild dogs in the Mkomazi Game Reserve in 2000. Phylogenetic analysis of a 335-nt fragment of the fusion (F) gene confirmed that the pack in 2007 was infected with a variant most closely related to one variant from 1994 during the epidemic in the Serengeti National Park from which a comparable fragment is available. Screening of tissue samples for concurrent infections revealed evidence of canine parvovirus, Streptococcus equi subsp. ruminatorum and Hepatozoon sp. No evidence of infection with Babesia sp. or rabies virus was found. Possible implications of concurrent infections are discussed. This is the first molecular characterisation of CDV in free-ranging African wild dogs and only the third confirmed case of fatal CDV infection in a free-ranging pack. Copyright © 2010 Elsevier B.V. All rights reserved.

  10. Bordetella pseudohinzii as a Confounding Organism in Murine Models of Pulmonary Disease. (United States)

    Clark, Sarah E; Purcell, Jeanette E; Sammani, Saad; Steffen, Earl K; Crim, Marcus J; Livingston, Robert S; Besch-Williford, Cynthia; Fortman, Jeffrey D


    A group studying acute lung injury observed an increased percentage of neutrophils in the bronchoalveolar lavage (BAL) fluid of mice. BAL was performed, and lung samples were collected sterilely from 5 C57BL/6 mice that had been bred inhouse. Pure colonies of bacteria, initially identified as Bordetella hinzii were cultured from 2 of the 5 mice which had the highest percentages of neutrophils (21% and 26%) in the BAL fluid. Subsequent sequencing of a portion of the ompA gene from this isolate demonstrated 100% homology with the published B. pseudohinzii sequence. We then selected 10 mice from the investigator's colony to determine the best test to screen for B. pseudohinzii in the facility. BAL was performed, the left lung lobe was collected for culture and PCR analysis, the right lung lobe and nasal passages were collected for histopathology, an oral swab was collected for culture, and an oral swab and fecal pellets were collected for PCR analysis. B. pseudohinzii was cultured from the oral cavity, lung, or both in 8 of the 10 mice analyzed. All 8 of these mice were fecal PCR positive for B. pseudohinzii; 7 had increased neutrophils (5% to 20%) in the BAL fluid, whereas the 8th mouse had a normal neutrophil percentage (2%). Active bronchopneumonia was not observed, but some infected mice had mild to moderate rhinitis. B. pseudohinzii appears to be a microbial agent of importance in mouse colonies that can confound pulmonary research. Commercial vendors and institutions should consider colony screening, routine reporting, and exclusion of B. pseudohinzii.

  11. [Clonidine as adjuvant therapy for alcohol withdrawal syndrome in intensive care unit: case report.]. (United States)

    Braz, Leandro Gobbo; Camacho Navarro, Lais Helena; Braz, José Reinaldo Cerqueira; Silva, Ubirajara Teixeira da; Yamaguti, Fábio Akio; Cristovan, José Carlos


    Sedation of patients with past history of alcohol and drug abuse in Intensive Care Units (ICU) is a challenge due to the high incidence of sedative drugs tolerance and withdrawal syndromes. This report aimed at describing a case of a young patient admitted to the ICU who developed alcohol withdrawal syndrome and tolerance to sedatives, resolved only after clonidine administration. Male patient, 18 years old, alcohol, tobacco, cocaine and marijuana abuser, victim of firearm accident, who was admitted to the ICU in the first post-enterectomy day, after gastric content aspiration during tracheal re-intubation. Clinical evolution was: vasoactive drugs up to the 4th day; bilateral bronchopneumonia with pleural effusion and need for artificial ventilation up to the 15th day. Initial sedation scheme was the association of midazolam and fentanyl. As from the 4th day, patient presented with several psychomotor agitation episodes, even after the association of lorazepam in the 6th day. In the 9th day, patient received the largest doses but remained agitated. Dexmedetomidine was associated, which has decreased other drug doses in 35% and has improved agitation. In the 12th day, midazolam and dexmedetomidine were replaced by propofol infusion with worsening of agitation. In the 13th day, clonidine was associated to the sedation scheme with total resolution of agitation. Propofol was withdrawn in the 14th day, fentanyl was maintained and midazolam infusion was restarted, with doses 75% and 65% lower as compared to peak doses of such drugs. Patient was extubated in the 15th day and was discharged from ICU. Benzodiazepines should remain the drugs of choice for the treatment of acute alcohol withdrawal syndrome. However in this report, only adjuvant clonidine was able to adequately treat the patient.

  12. Pediatric Visceral Leishmaniasis in Albania: A Retrospective Analysis of 1,210 Consecutive Hospitalized Patients (1995–2009) (United States)

    Petrela, Raida; Kuneshka, Loreta; Foto, Eli; Zavalani, Ferit; Gradoni, Luigi


    Background Little information is available about infantile visceral leishmaniasis (VL) in Albania as regards incidence, diagnosis and management of the disease. Methodology/Principal Findings Demographic data, clinical and laboratory features and therapeutic findings were considered in children admitted to University Hospital of Tirana from 1995 to 2009, and diagnosed as having VL. The diagnosis was based on bone-marrow microscopy/culture in 77.5% of patients, serology in 16.1%, and ex juvantibus in 6.4%. A total of 1,210 children were considered, of whom 74% came from urbanized areas. All patients were in the age range 0–14 years, with a median of 4 years. Hepatosplenomegaly was recorded in 100%, fever in 95.4% and moderate to severe anemia in 88% of cases. Concomitant conditions were frequent: 84% had bronchopneumonia; diarrhea was present in 27%, with acute manifestations in 5%; 3% had salmonellosis. First-line therapy was meglumine antimoniate for all patients, given at the standard Sbv dosage of 20 mg/kg/day for 21 to 28 days. Two children died under treatment, one of sepsis, the other of acute renal impairment. There were no cases of primary unresponsiveness to treatment, and only 8 (0.67%) relapsed within 6–12 months after therapy. These patients have been re-treated with liposomal amphotericin B, with successful cure. Conclusions Visceral leishmaniasis in pediatric age is relatively frequent in Albania; therefore an improvement is warranted of a disease-specific surveillance system in this country, especially as regards diagnosis. Despite recent reports on decreased responses to antimonial drugs of patients with Mediterranean VL, meglumine antimoniate treatment appears to be still highly effective in Albania. PMID:20838650

  13. Pediatric visceral leishmaniasis in Albania: a retrospective analysis of 1,210 consecutive hospitalized patients (1995-2009). (United States)

    Petrela, Raida; Kuneshka, Loreta; Foto, Eli; Zavalani, Ferit; Gradoni, Luigi


    Little information is available about infantile visceral leishmaniasis (VL) in Albania as regards incidence, diagnosis and management of the disease. Demographic data, clinical and laboratory features and therapeutic findings were considered in children admitted to University Hospital of Tirana from 1995 to 2009, and diagnosed as having VL. The diagnosis was based on bone-marrow microscopy/culture in 77.5% of patients, serology in 16.1%, and ex juvantibus in 6.4%. A total of 1,210 children were considered, of whom 74% came from urbanized areas. All patients were in the age range 0-14 years, with a median of 4 years. Hepatosplenomegaly was recorded in 100%, fever in 95.4% and moderate to severe anemia in 88% of cases. Concomitant conditions were frequent: 84% had bronchopneumonia; diarrhea was present in 27%, with acute manifestations in 5%; 3% had salmonellosis. First-line therapy was meglumine antimoniate for all patients, given at the standard Sb(v) dosage of 20 mg/kg/day for 21 to 28 days. Two children died under treatment, one of sepsis, the other of acute renal impairment. There were no cases of primary unresponsiveness to treatment, and only 8 (0.67%) relapsed within 6-12 months after therapy. These patients have been re-treated with liposomal amphotericin B, with successful cure. Visceral leishmaniasis in pediatric age is relatively frequent in Albania; therefore an improvement is warranted of a disease-specific surveillance system in this country, especially as regards diagnosis. Despite recent reports on decreased responses to antimonial drugs of patients with Mediterranean VL, meglumine antimoniate treatment appears to be still highly effective in Albania.

  14. Bovine respiratory disease associated with Histophilus somni and bovine respiratory syncytial virus in a beef cattle feedlot from Southeastern Brazil

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    Selwyn Arligton Headley


    Full Text Available Bovine respiratory disease (BRD is a complex multifactorial and multi-etiological disease entity that is responsible for the morbidity and mortality particularly in feedlot cattle from North America. Information relative to the occurrence of BRD in Brazil and the associated infectious agents are lacking. This study investigated the participation of infectious agents of BRD in a beef cattle feedlot from Southeastern Brazil. Nasopharyngeal swabs of 11% (10/90 of cattle (n, 450 with clinical manifestations of respiratory distress were analyzed by targeting specific genes of the principal infectious pathogens of BRD. In addition, pulmonary fragments of one the animals that died were collected for histopathological and molecular diagnoses. The nucleic acids of Histophilus somni and bovine respiratory syncytial virus (BRSV were identified in 20% (2/10 of the nasopharyngeal swabs of the animals with respiratory distress; another contained only BRSV RNA. Moreover, the nucleic acids of both infectious agents were amplified from the pulmonary fragments of the animal that died with histopathological evidence of bronchopneumonia and interstitial pneumonia; the nasopharyngeal swab of this animal also contained the nucleic acids of both pathogens. Additionally, all PCR and/or RT-PCR assays designed to detect the specific genes of Mannheimia haemolytica, Pasteurella multocida, Mycoplasma bovis, bovine viral diarrhea virus, bovine herpesvirus -1, bovine parainfluenza virus-3, and bovine coronavirus yielded negative results. Phylogenetic analyses suggest that the isolates of H. somni circulating in Brazil are similar to those identified elsewhere, while there seem to be diversity between the isolates of BRSV within cattle herds from different geographical locations of Brazil.


    Taurisano, Nicole D; Butler, Brian P; Stone, Diana; Hariharan, Harry; Fields, Paul J; Ferguson, Hugh W; Haulena, Martin; Cotrell, Paul; Nielsen, Ole; Raverty, Stephen


    :  Streptococcus phocae is a pathogen of marine mammals, although its pathogenicity remains poorly understood. Recovery of this bacterium from asymptomatic carriers suggests that it is an opportunistic pathogen. We investigated the role of S. phocae in naturally occurring disease and its significance as a pathogen based on postmortem investigations. Between 2007 and 2012, 1,696 whole carcasses, tissue samples, or both were submitted from the northeastern Pacific and Arctic Canada for diagnostic testing. Streptococcus phocae was cultured from phocids ( n=66), otariids ( n=12), harbor porpoises ( Phocoena phocoena; n=5), and sea otters ( Enhydra lutris; n=2). Pathologic manifestations of S. phocae-associated disease included localized, as well as systemic, inflammatory lesions with common findings of suppurative bronchopneumonia ( n=17) and bacteremia ( n=27). Lung lesions were frequently culture-positive for S. phocae, suggesting commensal colonization of the oropharynx with subsequent opportunistic infection of the respiratory tract during tissue injury, coinfection, immunosuppression, or other debilitating conditions. The presence of a positive spleen culture, and interpretations at necropsy and histopathology, were used to determine the presence of S. phocae bacteremia. Less frequent lesions that were culture positive for S. phocae included abscesses ( n=9), meningitis ( n=7), and cellulitis ( n=1). The majority of cases with S. phocae lesions featured pre-existing conditions that presumably contributed to some degree of debilitation or immunosuppression, including emaciation ( n=29), liver mercury accumulation ( n=29), trauma ( n=22), severe pulmonary or cardiovascular nematodiasis ( n=9), concurrent bacterial or viral infections ( n=8), or sarcocystosis ( n=6). These findings suggest that S. phocae could be characterized as an opportunistic pathogen, associated with debilitating conditions in stranded and rehabilitating marine mammals. Wildlife investigators

  16. Isolation, characterization, antibiogram and pathology of Pasteurella multocida isolated from pigs

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    Mamta Tigga


    Full Text Available Aim: Isolation, characterization and antibiogram of Pasteurella multocida from diseased pigs of district Durg of Chhattisgarh, and to study pathological changes caused by swine pasteurellosis. Materials and Methods: An outbreak of swine pasteurellosis was suspected in pigs of Ruwabandha (Bhilai, Anjora, Somni, Tedesara, Tirgajhola villages of Durg district in Chhattisgarh, India during August and September of 2011. Nasal Swabs and blood samples from ailing pigs and heart blood and impression smears from morbid pigs were processed for detection and isolation of P. multocida by bacteriological methods. Detailed necropsy was conducted and gross and histopathological lesions were recorded. The test Isolates were subjected to antimicrobial sensitivity profile by disc-diffusion method. Results: The blood smears from heart blood and tissue impression smears revealed teaming of bipolar organisms indicating the presence of Pasteurella spp. The isolates obtained were subjected to Gram's staining for checking the purity and bipolar morphology and characterized biochemically. Gross lesions included severe acute pneumonia and haemorrhages in lungs, petechial haemorrhages on serous membranes and other visceral organs. On histopathological examination, lungs showed typical fibrinous bronchopneumonia, multifocal suppuration. All the isolates of P. multocida were 100% sensitive to Amoxicillin, Gentamicin, Enrofloxacin and showed100% resistance to Ceftizoxim and Cloxacillin. Conclusion: Gross and microscopic lesions in dead animals are of great diagnostic value and are of characteristic of P. multocida infection. Cultural, morphological and biochemical characters are useful to rule out the causative agent as P. multocida. Antibiotic sensitivity pattern of the isolates should routinely be carried out for knowing the antibiotic resistance trends in an endemic area.

  17. Adenovirus serotype 3 and 7 infection with acute respiratory failure in children in Taiwan, 2010-2011.

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    Chen-Yin Lai

    Full Text Available OBJECTIVE: Increased incidence of adenovirus infection in children was noticed since September 2010 in Taiwan and severe cases requiring intensive care were noted later. We did this study to find the clinical characteristics and risk factors associated with severe adenovirus infection. PATIENTS AND METHODS: We collected cases of severe adenovirus infection between November 2010 and June 2011 to analyze their clinical characteristics in two medical centers in northern Taiwan. Severe adenovirus infection was defined as laboratory-confirmed adenovirus cases with required intensive care. Hexon gene sequencing was performed for molecular genotyping. RESULTS: 45 patients were included, 22 cases (49% were infected with serotype 7, 19 (42% with serotype 3, and 4 with serotype 2. The median age (range was 2.75 years (0.08-15.43 years; 87% were below 5 years. Male to female ratio was 1.65 (28 to 17. Of these patients, 56% had underlying neurological diseases, 50% experienced fever higher than 40°C and 69% suffered fever longer than one week. The clinical diagnosis included pneumonia in 40 (89% patients, bronchopneumonia in 5 (11%, and encephalitis in 7 (16%. At least 22 patients had pleural effusion. They had complications of respiratory failure (53%, acute respiratory distress syndrome (24%, hypotension (40%, and 6 (13% patients needed extracorporeal membranous oxygenation. Ten (22% patients died, all with underlying major systemic diseases and 7 (70% infected with serotype 7. CONCLUSIONS: Adenovirus serotype 7 and 3 can cause severe disease-even death-in children, especially those with underlying neurological diseases. Patients infected with adenovirus serotype 7 tended to have a higher case-fatality rate.

  18. Influence of acute renal failure on the mononuclear phagocytic system

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    V.R.A. Sousa


    Full Text Available Several studies show the ability of macrophages to remove particles injected into the bloodstream. This function seems to be increased in the presence of acute renal failure. The objective of the present study was to assess the phagocytic function of the main organs (spleen, liver and lung of the mononuclear phagocytic system in renal and postrenal failures. Fifteen rats (250-350 g were divided into three groups (N = 5: group I - control; group II - ligature of both ureters, and group III - bilateral nephrectomy. On the third postoperative day, all animals received an iv injection of 1 ml/kg 99mTc sulfur colloid. Blood samples were collected for the assessment of plasma urea, creatinine, sodium, and potassium concentrations and arterial gasometry. Samples of liver, spleen, lung and blood clots were obtained and radioactivity was measured. Samples of liver, spleen, lung and kidney were prepared for routine histopathological analysis. Plasma urea, creatinine and potassium concentrations in groups II and III were higher than in group I (P<0.05. Plasma sodium concentrations in groups II and III were lower than in group I (P<0.05. Compensated metabolic acidosis was observed in the presence of postrenal failure. Group II animals showed a lower level of radioactivity in the spleen (0.98 and lung (2.63, and a higher level in the liver (105.51 than control. Group III animals showed a lower level of radioactivity in the spleen (11.94 and a higher level in the liver (61.80, lung (11.30 and blood clot (5.13 than control. In groups II and III liver steatosis and bronchopneumonia were observed. Renal and postrenal failures seem to interfere with blood clearance by the mononuclear phagocytic system.

  19. Exposure of bighorn sheep to domestic goats colonized with Mycoplasma ovipneumoniae induces sub-lethal pneumonia. (United States)

    Besser, Thomas E; Cassirer, E Frances; Potter, Kathleen A; Foreyt, William J


    Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis) that has been associated with contact with domestic Caprinae. The disease is polymicrobial but is initiated by Mycoplasma ovipneumoniae, which is commonly carried by both domestic sheep (O. aries) and goats (Capra aegagrus hircus). However, while previous bighorn sheep comingling studies with domestic sheep have resulted in nearly 100% pneumonia mortality, only sporadic occurrence of fatal pneumonia was reported from previous comingling studies with domestic goats. Here, we evaluated the ability of domestic goats of defined M. ovipneumoniae carriage status to induce pneumonia in comingled bighorn sheep. In experiment 1, three bighorn sheep naïve to M. ovipneumoniae developed non-fatal respiratory disease (coughing, nasal discharge) following comingling with three naturally M. ovipneumoniae-colonized domestic goats. Gross and histological lesions of pneumonia, limited to small areas on the ventral and lateral edges of the anterior and middle lung lobes, were observed at necropsies conducted at the end of the experiment. A control group of three bighorn sheep from the same source housed in isolation during experiment 1 remained free of observed respiratory disease. In experiment 2, three bighorn sheep remained free of observed respiratory disease while comingled with three M. ovipneumoniae-free domestic goats. In experiment 3, introduction of a domestic goat-origin strain of M. ovipneumoniae to the same comingled goats and bighorn sheep used in experiment 2 resulted in clinical signs of respiratory disease (coughing, nasal discharge) in both host species. At the end of experiment 3, gross and histological evidence of pneumonia similar to that observed in experiment 1 bighorn sheep was observed in both affected bighorn sheep and domestic goats. M. ovipneumoniae strains carried by domestic goats were transmitted to comingled bighorn sheep, triggering development of pneumonia. However

  20. Atypical presentation of human bocavirus: Severe respiratory tract infection complicated with encephalopathy. (United States)

    Akturk, Hacer; Sık, Guntulu; Salman, Nuran; Sutcu, Murat; Tatli, Burak; Ciblak, Meral Akcay; Erol, Oguz Bulent; Torun, Selda Hancerli; Citak, Agop; Somer, Ayper


    Human bocavirus (HBOV) has been reported as a worldwide distributed respiratory pathogen. It has also been associated with encephalitis recently by detection of the virus in cerebrospinal fluid (CSF) of patients presented with encephalitis. This retrospective study aimed to present clinical features of HBOV infections in children with respiratory symptoms and describe unexplained encephalopathy in a subgroup of these patients. Results of 1,143 pediatric nasal samples from mid-December 2013 to July 2014 were reviewed for detection of HBOV. A multiplex real time polymerase chain reaction assay was used for viral detection. Medical records of the patients were retrospectively analyzed. HBOV was detected in 30 patients (2.6%). Median age was 14 months (5-80). Clinical diagnoses were upper respiratory tract infection (n = 10), bronchopneumonia (n = 9), acute bronchiolitis (n = 5), pneumonia (n = 4), acute bronchitis (n = 1), and asthma execarbation (n = 1). Hospitalization was required in 16 (53.3%) patients and 10 (62.5%) of them admitted to pediatric intensive care unit (PICU). Noninvasive mechanical ventilation modalities was applied to four patients and mechanical ventilation to four patients. Intractable seizures developed in four patients while mechanically ventilated on the 2nd-3rd days of PICU admission. No specific reason for encephalopathy was found after a thorough investigation. No mortality was observed, but two patients were discharged with neurological sequela. HBOV may lead to respiratory infections in a wide spectrum of severity. This report indicates its potential to cause severe respiratory infections requiring PICU admission and highlights possible clinical association of HBOV and encephalopathy, which developed during severe respiratory infection. © 2015 Wiley Periodicals, Inc.


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    Fischer 344 rats were exposed to 0.0, 0.4, 1.4, or 4.0 ppm acrolein for 62 days. The major objective of the study was to relate the results of a series of pulmonary function tests to biochemical and pathological alterations observed in the lung. Cytological and reproductive potential endpoints were also assessed after acrolein exposure. Rats were exposed to acrolein for 6 hours/day, 5 days/week for 62 days. Mortality was observed only in the 4.0 ppm chamber where 32 of 57 exposed males died; however, none of the 8 exposed females died. Most of the mortality occurred within the first 10 exposure days. Histologic examination indicated that the animals died of acute bronchopneumonia. The surviving males and females exposed to 4.0 ppm acrolein gained weight at a significantly slower rate than control animals. The growth of both sexes in the 0.4 and 1.4 ppm groups was similar to that of their respective controls. Histopathologic examination of animals after 62 days of exposure revealed bronchiolar epithelial necrosis and sloughing, bronchiolar edema with macrophages, and focal pulmonary edema in the 4.0 ppm group. These lesions were, in some cases, associated with edema of the trachea and peribronchial lymph nodes, and acute rhinitis which indicated an upper respiratory tract effect of acrolein. Of particular interest was the variability of response between rats in the 4.0 ppm group, some not affected at all while others were moderately affected. Intragroup variability in toxicity was also apparent in the 1.4 ppm exposure group where only 3 of 31 animals examined had lesions directly related to acrolein exposure. Extra respiratory organs appeared unaffected.

  2. Enfermedad cerebrovascular: Seguimiento y rehabilitación en la comunidad

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    Clara Raisa Vera Miyar


    Full Text Available Se realizó un estudio de pacientes adultos que sufrieron enfermedades cerebrovasculares (ECV en 38 consultorios pertenecientes al área urbana del Policlínico "Idalberto Revuelta" de la ciudad de Sagua la Grande en el período comprendido de septiembre de 1995 a septiembre de 1997. Se determinó su comportamiento y seguimiento en los consultorios médicos, encontrándose un predominio en general de la ECV de tipo isquémico en las personas mayores de 63 años; a su vez la hipertensión arterial fue el factor de riesgo fundamental, seguido del hábito de fumar y las enfermedades cardíacas. Los pacientes con ECV isquémica, que fueron en su mayoría adultos mayores, presentaron mayor capacidad de independencia respecto a los hemorrágicos, y esto a su vez guardó estrecha relación con la ventana terapéutica y la rehabilitación. La complicación más frecuente fue la bronconeumoníaA study of adult patients who suffered cerebrovascular diseases (CVD was conducted at 38 family physician's offices corresponding to the urban area of "Idalbero Revuelta" Polyclinic, in the city of Sagua la Grande, from September, 1995, to September, 1997. Their behavior and follow-up at the family physician's offices was determined and it was found a predominance in general of CVD of ischemic type in individuals over 63. Arterial hypertension was the fundamental risk factor, followed by smoking habit and heart diseases. Those patients with ischemic CVD that were mostly older adults had a greater capacity of independence compared with the hemorrhagic patients. This had a close relation with the therapeutic window and rehabilitation. Bronchopneumonia was the most frequent complication.

  3. Antimicrobial susceptibility, serotypes and genotypes of Pasteurella multocida isolates associated with swine pneumonia in Taiwan. (United States)

    Yeh, Jih-Ching; Lo, Dan-Yuan; Chang, Shao-Kuang; Chou, Chi-Chung; Kuo, Hung-Chih


    Pasteurella multocida (PM) can cause progressive atrophic rhinitis and suppurative bronchopneumonia in pigs. The present study performed antimicrobial susceptibility testing and serotype and genotype identification on the 62 PM strains isolated from the lungs of diseased pigs with respiratory symptoms. Antimicrobial susceptibility testing examined 13 antimicrobial agents (amoxicillin, cefazolin, doxycycline, flumequine, enrofloxacin, florfenicol, kanamycin, lincomycin, Linco-Spectin (lincomycin and spectinomycin), erythromycin, tylosin, tilmicosin and tiamulin). Antimicrobial resistance ratios were over 40% in all of the antimicrobial agents except for cefazolin. The highest levels of resistance (100%) were found for kanamycin, erythromycin and tylosin. The majority of isolated strains was serotype D:L6 (n=35) followed by A:L3 (n=17). Comparison of the antimicrobial resistance levels between the two serotypes showed that the antimicrobial resistance rates were higher in D:L6 than in A:L3 for all the tested antimicrobials except for tylosin and tilmicosin. For PM with erm(B), erm(T) or erm(42), the results showed no significant difference compared with non-resistance gene strains in phenotype. Pulsed-field gel electrophoresis genotyping using ApaI restriction digestion of the genomic DNA demonstrated that there were 17 distinct clusters with a similarity of 85% or more, and the genotyping result was similar to that of serotyping. The results of the present study demonstrated that the PM isolated from diseased pigs in Taiwan was resistant to multiple antimicrobials, and the distribution of antimicrobial resistance was associated with pulsotype and serotype. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Development and characterization of a caprine aerosol infection model of melioidosis.

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    Carl Soffler

    Full Text Available Infection with Burkholderia pseudomallei causes the disease melioidosis, which often presents as a serious suppurative infection that is typically fatal without intensive treatment and is a significant emerging infectious disease in Southeast Asia. Despite intensive research there is still much that remains unknown about melioidosis pathogenesis. New animal models of melioidosis are needed to examine novel aspects of pathogenesis as well as for the evaluation of novel therapeutics. The objective of the work presented here was to develop a subacute to chronic caprine model of melioidosis and to characterize the progression of disease with respect to clinical presentation, hematology, clinical microbiology, thoracic radiography, and gross and microscopic pathology. Disease was produced in all animals following an intratracheal aerosol of 10(4 CFU delivered, with variable clinical manifestations indicative of subacute and chronic disease. Bronchointerstitial pneumonia was apparent microscopically by day 2 and radiographically and grossly apparent by day 7 post infection (PI. Early lesions of bronchopneumonia soon progressed to more severe bronchointerstitial pneumonia with pyogranuloma formation. Extrapulmonary dissemination appeared to be a function of pyogranuloma invasion of pulmonary vasculature, which peaked around day 7 PI. Histopathology indicated that leukocytoclastic vasculitis was the central step in dissemination of B. pseudomallei from the lungs as well as in the establishment of new lesions. While higher doses of organism in goats can produce acute fatal disease, the dose investigated and resulting disease had many similarities to human melioidosis and may warrant further development to provide a model for the study of both natural and bioterrorism associated disease.

  5. Clinico-pathological discrepancies in the diagnosis of causes of maternal death in sub-Saharan Africa: retrospective analysis.

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    Jaume Ordi


    Full Text Available BACKGROUND: Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. METHODS AND FINDINGS: A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n = 139 during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death. Major diagnostic errors were detected in 56 (40.3% maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%, pyogenic bronchopneumonia (35.3%, pyogenic meningitis (40.0%, and puerperal septicemia (50.0%. Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%. CONCLUSIONS: Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

  6. Vaccinia viruses isolated from cutaneous disease in horses are highly virulent for rabbits. (United States)

    Felipetto Cargnelutti, Juliana; Schmidt, Candice; Masuda, Eduardo Kenji; Braum, Lisiane Danusa; Weiblen, Rudi; Furtado Flores, Eduardo


    Two genotypically distinct Vaccinia viruses (VACV), named P1V and P2V, were isolated from an outbreak of cutaneous disease in horses in Southern Brazil. We herein investigated the susceptibility of rabbits, a proposed animal model, to P1V and P2V infection. Groups of weanling rabbits were inoculated intranasally (IN) with P1V or P2V at low (10(2.5) TCID50), medium (10(4.5)TCID50), or high titer (10(6.5)TCID50). Rabbits inoculated with medium and high titers shed virus in nasal secretions and developed serous to hemorrhagic nasal discharge and severe respiratory distress, followed by progressive apathy and high lethality. Clinical signs appeared around days 3-6 post-inoculation (pi) and lasted up to the day of death or euthanasia (around days 5-10). Virus shedding and clinical signs were less frequent in rabbits inoculated with low virus titers. Viremia was detected in all groups, with different frequencies. Viral DNA was detected in the feces of a few animals inoculated with P1V and P2V, low titer, and with P2V at high titer. Gross necropsy findings and histological examination showed diffuse interstitial fibrousing pneumonia with necrosuppurative bronchopneumonia and intestinal liquid content. Neutralizing antibodies were detected in all inoculated animals surviving beyond day 9 pi. These results show that rabbits are highly susceptible to VACV isolated from horses, and develop severe respiratory and systemic disease upon IN inoculation. Thus, rabbits may be used to study selected aspects of VACV infection and disease. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. [Radiographic and computed tomographic manifestations of chest in patients with acute chlorine gas poisoning]. (United States)

    Liu, Zhen-juan; Huang, De-jian; Wang, Zhong-qiu; Wang, Zheng-ge; Chang, Shuang-hui; Wu, Zheng-can


    To investigate the radiographic and computerized tomographic features of chest in patients with acute chlorine poisoning and its diagnostic value. Twenty-eight cases of chlorine poisoning were reviewed. And their radiographic and computerized tomographic features were compared and analyzed. Radiographic findings: among 28 patients, 9 cases were normal and 2 cases had no abnormalities on the first chest X-ray and became abnormal one or two days later. And there were abnormal findings in first chest X-ray in 17 patients:acute tracheal inflammation of peribronchitis (n = 3), acute chemical bronchopneumonia (n = 6) and diffuse interstitial and central pulmonary edema (n = 8). CT manifestations: At Days 1-3, the patients of mild poisoning had scattered patchy dense shadow; those of moderate to severe poisoning showed multiple patchy or diffuse infiltration (ground-glass opacity). And partial consolidation, air bronchogram and pleural effusion could be observed. At Days 4-10, the manifestations of mild poisoning were largely absorbed; those of moderate to severe poisoning manifested the absorption of diffuse or multiple patchy effusion and a fading of shadow. And the size of lung consolidation became smaller than before. At Day 10 after onset, 4 patients completely recovered. At Days 30-40, 6 cases showed traces of fibrous shadow and one case showed small punctiform opacities in both lungs. And at Day 42, there was slight ground-glass change. Acute chlorine gas poisoning in varying degrees may manifest acute bronchial pneumonia and acute pulmonary edema. During treatment, a series of chest X-ray examinations will help to follow the changes of disease. And CT examination can offer a more accurate evaluation of lung lesions.

  8. Abdomen agudo quirúrgico en el anciano

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    Jesús M Valdés Jiménez


    Full Text Available Se presenta un estudio descriptivo retrospectivo de 156 enfermos mayores de 65 años, con diagnóstico de abdomen agudo quirúrgico (AAQ, operados en el Hospital Clinicoquirúrgico «Manuel Fajardo» e ingresados en la Unidad de Cuidados Intermedios Polivalente, durante el trienio comprendido entre 1995 y 1998. Las causas más frecuentes del síndrome fueron la oclusión intestinal (58,9 %, la colecistitis aguda (13,5 % y la úlcera péptica gastroduodenal perforada (10,9 %. Las enfermedades asociadas de mayor prevalencia eran la cardiopatía isquémica (62,2 % y la hipertensión arterial (48,7 %. La mortalidad aumentó con el avance de la edad, y alcanzó el 70,4 % en los mayores de 85 años. Entre las complicaciones predominaron la infección de la herida quirúrgica (12,8 % y la bronconeumonía (5,8 %. La principal causa de muerte fue la sepsis (10,3 %A descriptive and retrospective study of 156 patients over 65 with diagnosis of acute surgical abdomen (ASA that were operated on at "Manuel Fajardo" Clinical and Surgical Hospital and admitted at the Polyvalent Intermediate Care Unit, from 1995 to 1998, was conducted. The most common causes of the syndrome were intestinal occlusion (58.9 %, acute cholecystitis (13.5 % and the gastroduodenal perforated peptic ulcer (10.9 %. The associated diseases of highest prevalence were ischemic heart disease (62.2 % and arterial hypertension (48.7 %. Mortality increased with age and amounted to 70.4 % in patients over 85. The infection of the surgical wound (12.8 % and bronchopneumonia (5.8% prevailed among the complications. Sepsis (10.3 % was the main cause of death

  9. Determinants of antibiotic prescription in paediatric patients: The case of two hospitals in Maputo, Mozambique

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    L G S Monteiro


    Full Text Available Background. The need for healthcare in paediatric patients is often due to respiratory diseases, acute diarrhoea and viral fever, which suggests a limited need for the use of antibiotics. Objectives. To identify the determinants of antibiotic prescription in hospitalised paediatric patients in Mozambique. Methods. A cross-sectional study was conducted between January and June 2015. A total of 454 medical prescriptions and clinical records of children aged 0 - 14 years from Hospital Central de Maputo (HCM and Hospital Geral de Mavalane (HGM were analysed. Results. Antibiotics were used in 97.6% of the patients, with no significant differences (p>0.05 in the prescription rates of the hospitals. The most commonly used antibiotics were beta-lactams (57.3%, aminoglycosides (28.3% and co-trimoxazole (9.4%. Antibiotics were prescribed in all cases of bronchopneumonia, fever, sepsis and acute gastroenteritis. For malaria and undefined diagnoses, antibiotics were prescribed 97.8% and 99.3% of cases, respectively. It was clear that most severe clinical conditions (odds ratio (OR 9.06; 1.13 - 12.14 and age <5 years (OR 5.47;1.54 - 7.60 were treated with antibiotics. Conclusion. The prescription of antibiotics for paediatric patients at both HCM and HGM was largely influenced by patients’ clinical condition and age. It showed that physicians used an empirical approach, in the absence of laboratory tests, often leading to unnecessary antibiotic treatments with negative causative effects. Physicians should be encouraged to use an evidence-based approach for managing the cases correctly.

  10. Swine flu outbreak 2015-Paediatric Experience in a Tertiary Care Centre.

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    Dr. Anuya Chauhan


    Full Text Available Background & Aim: To study and analyse the clinical profile and outcome of children admitted with Influenza A positive cases at our Tertiary Care Centre in 2015. Materials & Methods: Prospective study conducted in a tertiary care centre (Civil Hospital B. J. Medical College, Ahmedabad from Jan 2015 to March 2015. 340 Children presenting with clinical features compatible with category C were admitted and 199 patients having laboratory confirmed influenza A (H1N1 were included in our study. Details regarding clinical features, examination findings, investigations, complications and treatment were recorded and analysed in a systemic manner. Results: Study showed that highest incidence of influenza A was seen in 1-3 years age group (41.7% Male-female ratio was 1.18:1 indicating similar affection of both sexes. Maximum patients presented within first 3 days of illness (53.2% with fever (82.9% followed by dry cough (74.6% and sore throat (52.7% as presenting symptoms. Leucopenia (79.4% was the most common laboratory finding and lobar pneumonia (81.1% was the most common radiological finding followed by bronchopneumonia (18.9%. Conjunctivitis (20.1% and otitis media (6.03% were the common complications. Mortality rate in our set up was 6.5% (13 out of 199; with maximum from 1-3 year age group (46.1%, most common cause being ARDS (46.1%. Conclusion: The outbreak of influenza A (H1N1 2015 predominantly affected young population with significant morbidity and mortality. With the efforts of healthcare authorities worldwide, we have still not lost the race against fighting this virus.

  11. Pathogenicity and molecular characterization of emerging porcine reproductive and respiratory syndrome virus in Vietnam in 2007. (United States)

    Metwally, S; Mohamed, F; Faaberg, K; Burrage, T; Prarat, M; Moran, K; Bracht, A; Mayr, G; Berninger, M; Koster, L; To, T L; Nguyen, V L; Reising, M; Landgraf, J; Cox, L; Lubroth, J; Carrillo, C


    In 2007, Vietnam experienced swine disease outbreaks causing clinical signs similar to the 'porcine high fever disease' that occurred in China during 2006. Analysis of diagnostic samples from the disease outbreaks in Vietnam identified porcine reproductive and respiratory syndrome virus (PRRSV) and porcine circovirus type 2 (PCV-2). Additionally, Escherichia coli and Streptococcus equi subspecies zooepidemicus were cultured from lung and spleen, and Streptococcus suis from one spleen sample. Genetic characterization of the Vietnamese PRRSV isolates revealed that this virus belongs to the North American genotype (type 2) with a high nucleotide identity to the recently reported Chinese strains. Amino acid sequence in the nsp2 region revealed 95.7-99.4% identity to Chinese strain HUN4, 68-69% identity to strain VR-2332 and 58-59% identity to strain MN184. A partial deletion in the nsp2 gene was detected; however, this deletion did not appear to enhance the virus pathogenicity in the inoculated pigs. Animal inoculation studies were conducted to determine the pathogenicity of PRRSV and to identify other possible agents present in the original specimens. Pigs inoculated with PRRSV alone and their contacts showed persistent fever, and two of five pigs developed cough, neurological signs and swollen joints. Necropsy examination showed mild to moderate bronchopneumonia, enlarged lymph nodes, fibrinous pericarditis and polyarthritis. PRRSV was re-isolated from blood and tissues of the inoculated and contact pigs. Pigs inoculated with lung and spleen tissue homogenates from sick pigs from Vietnam developed high fever, septicaemia, and died acutely within 72 h, while their contact pigs showed no clinical signs throughout the experiment. Streptococcus equi subspecies zooepidemicus was cultured, and PRRSV was re-isolated only from the inoculated pigs. Results suggest that the cause of the swine deaths in Vietnam is a multifactorial syndrome with PRRSV as a major factor. © 2010

  12. Human parainfluenza virus types 1-4 in hospitalized children with acute lower respiratory infections in China. (United States)

    Xiao, Ni-Guang; Duan, Zhao-Jun; Xie, Zhi-Ping; Zhong, Li-Li; Zeng, Sai-Zhen; Huang, Han; Gao, Han-Chun; Zhang, Bing


    Human parainfluenza viruses (HPIVs) are an important cause of acute lower respiratory tract infections (ALRTIs). HPIV-4, a newly identified virus, has been associated with severe ALRTIs recently. A total of 771 nasopharyngeal aspirate samples were collected from hospitalized children between March 2010 and February 2011. HPIVs were detected by Nest-PCR, and other known respiratory viruses were detected by RT-PCR and PCR. All amplification products were sequenced. HPIVs were detected in 151 (19.58%) patients, of whom 28 (3.63%) were positive for HPIV-4, 12(1.55%) for HPIV-1, 4 (0.51%) for HPIV-2, and 107 (13.87%) for HPIV-3. Only three were found to be co-infected with different types of HPIVs. All HPIV-positive children were under 5 years of age, with the majority being less than 1 year. Only the detection rate of HPIV-3 had a significant statistical difference (χ 2  = 29.648, P = 0.000) between ages. HPIV-3 and HPIV-4 were detected during the summer. Sixty (39.74%) were co-infected with other respiratory viruses, and human rhinovirus (HRV) was the most common co-infecting virus. The most frequent clinical diagnosis was bronchopneumonia, and all patients had cough; some patients who were infected with HPIV-3 and HPIV-4 had polypnea and cyanosis. No significant difference was found in clinical manifestations between those who were infected with HPIV-4 and HPIV-3. Two genotypes for HPIV-4 were prevalent, although HPIV-4a dominated. HPIV-4 is an important virus for children hospitalized with ALRTIs in China. HRV was the most common co-infecting virus. Two genotypes for HPIV-4 are prevalent, HPIV-4a dominated. J. Med. Virol. 88:2085-2091, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Prevalence and clinical and molecular characterization of human metapneumovirus in children with acute respiratory infection in China. (United States)

    Xiao, Ni-guang; Xie, Zhi-ping; Zhang, Bing; Yuan, Xin-hui; Song, Jing-rong; Gao, Han-chun; Zhang, Rong-fang; Hou, Yun-de; Duan, Zhao-jun


    Human metapneumovirus (HMPV), a newly discovered paramyxovirus, has been associated with acute respiratory tract infections (ARTIs). However, the prevalence and molecular characteristics of HMPV in China are still unclear. A total of 661 nasopharyngeal aspirates (NPA) specimens were collected from 661 children with ARTIs between December 2006 and November 2008. Specimens were screened for HMPV by reverse transcription-polymerase reaction. All positive amplification products were confirmed by sequencing. HMPV was detected in 45 patients (6.80%) of the 661 children. The HMPV-infected patients were from 29 days to 9 years of age. A high incidence of HMPV infection (84.4%) was observed during the winter-spring season. Of the 45 HMPV-positive patients, 25 (55.6%) were co-infected with other respiratory viruses, and respiratory syncytial virus (RSV) was the most common additional respiratory virus. The most common clinical diagnosis was bronchopneumonia (57.8%) and cough (88.9%) was the most common clinical symptom. Phylogenetic analysis of the F gene revealed that 80% of the HMPV detected were A2, 2.2% were A1, and 17.8% were B1. Statistical analyses showed that sex, ages, seasons, and severity of the disease did not correlate with HMPV genotype (P = 0.986, 0.347, 0.660, 0.252), but viral coinfection with HMPV increased hospitalization rates (P = 0.005). HMPV was frequently detected in the pediatric patients with ARTI in China. RSV was the most common coinfection virus and coinfection increased hospitalization rates. All HMPV subgroups except B2 cocirculated and there was no association found between HMPV genotypes and severity of disease.

  14. [Prevalence and clinical characteristics of coronavirus NL63 infection in children hospitalized for acute lower respiratory tract infections in Changsha]. (United States)

    Zhang, Fei; Zhang, Bing; Xie, Zhi-Ping; Gao, Han-Chun; Zhao, Xin; Zhong, Li-Li; Zhou, Qiong-Hua; Hou, Yun-De; Duan, Zhao-Jun


    The main objective of this study was to explore the prevalence and clinical characteristics of human coronavirus NL63 infection in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha. Nasopharyngeal aspirates (NPA) samples were collected from 1185 hospitalized children with ALRTI at the People's Hospital of Hunan province, between September 2008 and October 2010. Reverse transcriptase polymerase chain reaction (RT-PCR) was employed to screen for coronavirus NL63, which is a 255 bp fragment of a part of N gene. All positive amplification products were confirmed by sequencing and compared with those in GenBank. The overall frequency of coronavirus NL63 infection was 0.8%, 6 (60%) out of the coronavirus NL63 positive patients were detected in summer, 2 in autumn, 1 in spring and winter, respectively. The patients were from 2 months to two and a half years old. The clinical diagnosis was bronchopneumonia (60%), bronchiolitis (30%), and acute laryngotracheal bronchitis (10%). Four of the 10 cases had critical illness, 4 cases had underlying diseases, and 7 cases had mixed infection with other viruses. The homogeneity of coronavirus NL63 with those published in the GenBank at nucleotide levels was 97%-100%. Coronavirus NL63 infection exists in hospitalized children with acute lower respiratory tract infection in Changsha. Coronavirus NL63 infections are common in children under 3 years of age. There is significant difference in the infection rate between the boys and the girls: the boys had higher rate than the girls. The peak of prevalence of the coronavirus NL63 was in summer. A single genetic lineage of coronavirus NL63 was revealed in human subjects in Changsha. Coronavirus NL63 may also be one of the lower respiratory pathogen in China.

  15. Mathematical model of mean age, mean arsenic dietary dose and age-specific prevalence rate from endemic chronic arsenic poisoning: a human toxicology study

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    Zald' ivar, R.; Ghai, G.L.


    The aim of this investigation was to develop a mathematical model of mean age, mean arsenic dietary dose, and age-specific prevalence rate for endemic chronic arsenic poisoning. Data on mean age (years), mean arsenic dietary dose (mg/kg body weight/day), and age-specific prevalence rate per 100,000 population for endemic chronic arsenic poisoning in Antofagasta Commune, northern Chile, for the 1968 to 1971 period, were collected. Endemic chronic arsenic poisoning means here chronic arsenical dermatosis associated with marked or sever symptoms (or signs) of chronic arsenic poisoning (chronic diarrhea, hepatic cirrohsis, chronic bronchitis, bronchiectasis, recurrent broncho-pneumonia, cardiomegaly, systemic occlusive arterial disease, cerebral thrombosis, etc.). There was a strong positive correlation between age-specific pevalence rate per 100,000 population and mean arsenic dose (r = + 0.9593) and a negative correlation between prevalence rate and mean age (r = 0.8789). These findings show that the prevalence rate declines with the advancing age and increases with the increase of arsenic dose. A multiple linear regression model E(y) = alpha + beta X1 + gamma X2, where y represents the age-specific prevalence rate per 100,000 population, X1 the mean arsenic dose, and X2 the mean age, was fitted to the data. The estimates of the parameters (alpha, beta, and gamma) were obtained by minimizing the residual sum of squares sigma(y - alpha - beta X1 - gamma X2)2. The following multiple linear regression equation was obtained: Y = 202.161 + 8452.455 X1 - 2.394 X2. Of the total variability in the prevalence rate, 96.22 percent was accounted for by the multiple regression.

  16. Identification of a novel host-specific IgG protease in Streptococcus phocae subsp. phocae. (United States)

    Rungelrath, Viktoria; Wohlsein, Jan Christian; Siebert, Ursula; Stott, Jeffrey; Prenger-Berninghoff, Ellen; von Pawel-Rammingen, Ulrich; Valentin-Weigand, Peter; Baums, Christoph G; Seele, Jana


    Streptococcus (S.) phocae subsp. phocae causes bronchopneumonia and septicemia in a variety of marine mammals. Especially in harbor seals infected with phocine distemper virus it plays an important role as an opportunistic pathogen. This study was initiated by the detection of IgG cleavage products in Western blot analysis after incubation of bacterial supernatant with harbor seal serum. Hence, the objectives of this study were the identification and characterization of a secreted IgG cleaving protease in S. phocae subsp. phocae isolated from marine mammals. To further identify the responsible factor of IgG cleavage a protease inhibitor profile was generated. Inhibition of the IgG cleaving activity by iodoacetamide and Z-LVG-CHN2 indicated that a cysteine protease is involved. Moreover, an anti-IdeS antibody directed against the IgG endopeptidase IdeS of S. pyogenes showed cross reactivity with the putative IgG protease of S. phocae subsp. phocae. The IgG cleaving factor of S. phocae subsp. phocae was identified through an inverse PCR approach and designated IdeP (Immunoglobulin G degrading enzyme of S. phocae subsp. phocae) in analogy to the cysteine protease IdeS. Notably, recombinant (r) IdeP is a host and substrate specific protease as it cleaves IgG from grey and harbor seals but not IgG from harbor porpoises or non-marine mammals. The identification of IdeP represents the first description of a protein in S. phocae subsp. phocae involved in immune evasion. Furthermore, the fact that IdeP cleaves solely IgG of certain marine mammals reflects functional adaption of S. phocae subsp. phocae to grey and harbor seals as its main hosts. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Lesões pulmonares provocadas pela nicotina por via subcutânea em ratos Influence of subcutaneous nicotine in the lungs of rats

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    Aldo da Cunha Medeiros


    Full Text Available OBJETIVO: Estudo com o objetivo de observar a influência da nicotina, aplicada pela via subcutânea, em pulmões de ratos. MÉTODOS: Foram utilizados 20 ratos Wistar pesando 235± 35g, separados aleatoriamente em 2 grupos iguais. O grupo I (n=10 recebeu nicotina na dose de 2 mg/Kg/dia pela via subcutânea durante 20 dias e o grupo II (n=10 recebeu placebo pela mesma via de administração. RESULTADOS: Os resultados mostraram que no grupo I ocorreu broncopneumonia em 3 (30% ratos, leucocitose alveolar em 10 (100% e leucocitose septal em 7 (70%. Atelectasia foi encontrada em 2 (20%. Transformados em escores, os dados totalizaram 52 pontos. Os escores das alterações observadas nos pulmões do grupo II atingiram 11 pontos (pOBJECTIVE: The aims of this study were to determine and quantify the influence of nicotine, applied subcutaneously, in the lungs of rats. METHODS: Twenty Wistar rats weighing 235±35g were randomly separated in two groups. The group I (n=10 received nicotine ( 2 mg/Kg body mass/day during 20 days and the group II (n=10 received placebo subcutaneously. RESULTS: The results illustrate that in the group I resulted bronchopneumonia in 3 (30% rats, alveolar leucocitosis in 10 (100%, septal leucocitosis in 7 (70% and atelectasia was found in 2 (20%. Transformed in scores, the data totalized 52 points. The scores of the lesions observed in the lungs of group II rats reached 11 points (p <0,05. CONCLUSION: These findings indicate and conclude that the use of nicotine subcutaneously can be implicated in significant lung lesions in rats, when compared with controls.

  18. Characterization of glycan binding specificities of influenza B viruses with correlation with hemagglutinin genotypes and clinical features. (United States)

    Wang, Ya-Fang; Chang, Chuan-Fa; Chi, Chia-Yu; Wang, Hsuan-Chen; Wang, Jen-Ren; Su, Ih-Jen


    The carbohydrate binding specificities are different among avian and human influenza A viruses and may affect the tissue tropism and transmission of these viruses. The glycan binding biology for influenza B, however, has not been systematically characterized. Glycan binding specificities of influenza B viral isolates were analyzed and correlated to hemagglutinin (HA) genotypes and clinical manifestations. A newly developed solution glycan array was applied to characterize the receptor binding specificities of influenza B virus clinical isolates from 2001 to 2007 in Taiwan. Thirty oligosaccharides which include α-2,3 and α-2,6 linkage glycans were subjected to analysis. The glycan binding patterns of 53 influenza B isolates could be categorized into three groups and were well correlated to their HA genotypes. The Yamagata-like strains predominantly bound to α-2,6-linkage glycan (24:29, 83%) while Victoria-like strains preferentially bound to both α-2,3- and α-2,6-linkage glycans (13:24, 54%). A third group of viruses bound to sulfated glycans and these all belonged to Victoria-like strains. Based on the HA sequences, Asn-163, Glu-198, Ala-202, and Lys-203 were conserved among Victoria-like strains which may influence their carbohydrate recognition. The viruses bound to dual type glycans were more likely to be associated with the development of bronchopneumonia and gastrointestinal illness than those bound only to α-2,6 sialyl glycans (P B viruses, and will contribute to virus surveillance and vaccine strain selection. Copyright © 2012 Wiley Periodicals, Inc.

  19. Proteinosis alveolar pulmonar Pulmonary alveolar proteinosis

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    Concepción Sánchez Infante


    Full Text Available La proteinosis alveolar pulmonar es una enfermedad respiratoria crónica, caracterizada por alteración en el metabolismo del surfactante, lo que determina su acumulación anormal en el espacio alveolar. Es una enfermedad extremadamente rara. Se han reportado solamente 500 casos en la literatura. Se describió por primera vez en 1958. Se presenta un caso de proteinosis alveolar pulmonar en un lactante de 2 meses, con desnutrición proteico energética, que ingresa por dificultad respiratoria e hipoxemia, y, con imágenes radiológicas de tipo retículo-nodulillar, en vidrio deslustrado, en el cual se plantea inicialmente el diagnóstico de bronconeumonía. Ante la evolución desfavorable y no respuesta al tratamiento, se realizó un estudio para descartar enfermedades pulmonares crónicas. El paciente fallece y se confirma el diagnóstico por anatomía patológica. Se realiza una revisión del tema.The pulmonary alveolar proteinosis is a chronic respiratory disease characterized by surfactant metabolism alteration determining its abnormal accumulation in the alveolar space. It is a disease very rare and in literature only 500 cases have been reported; it was described for the first time in 1958. This is a case presentation of pulmonary alveolar proteinosis in an infant aged 2 months with energetic protein malnutrition admitted due to respiratory difficulty and hypoxemia and with radiologic images of the reticulonodulillary, in frosting glass, where initially is made the diagnosis of bronchopneumonia. In the face of unfavorable evolution and no response to treatment, a study was conducted to rule out chronic pulmonary diseases. Patient died confirming the diagnosis according to the pathologic anatomy. A review on subject is carried out.

  20. The changing epidemiology of infection in burn patients. (United States)

    Pruitt, B A; McManus, A T


    Topical chemotherapy, prompt excision, and timely closure of the burn wound have significantly reduced the occurrence of invasive burn wound infection and its related mortality. Since wound protection is imperfect and invasive wound infection may still occur in patients with massive burns in whom wound closure is delayed, scheduled wound surveillance and biopsy monitoring are necessary to assess the microbial status of the burn wound and identify wound infections caused by resistant bacteria or non-bacterial opportunists at a stage when therapeutic intervention can control the process. As a reflection of the systemic immunosuppressive effects of burn injury, infection remains the most common cause of morbidity and mortality even though the occurrence of wound infections has been significantly decreased. Pneumonia is the most frequent infection occurring in burn patients today but the improvements in patient management, wound care, and infection control have made bronchopneumonia the most common form of this infection and gram-positive organisms the most common causative agents. The organisms causing bacteremia that exert a species specific effect on the mortality related to extent of burn injury and patient age have changed in concert with changes in wound flora. Infection control procedures, including scheduled surveillance cultures, utilization of cohort patient care methodology, strict enforcement of patient and staff hygiene, and patient monitoring have been effective in eliminating endemic resistant microbial strains, preventing the establishment of newly introduced resistant organisms, diagnosing infection in a timely fashion, instituting antibiotic and other necessary therapy in a prompt manner, and documenting the effectiveness of present day burn patient care and the improved survival of burn patients.

  1. Clinical features and phylogenetic analysis of Coxsackievirus A9 in Northern Taiwan in 2011

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    Huang Yi-Chuan


    Full Text Available Abstract Background Coxsackievirus A9 (CA9 was one of the most prevalent serotype of enteroviral infections in Taiwan in 2011. After several patient series were reported in the 1960s and 1970s, few studies have focused on the clinical manifestations of CA9 infections. Our study explores and deepens the current understanding of CA9. Methods We analyzed the clinical presentations of 100 culture-proven CA9-infected patients in 2011 by reviewing their medical records and depicted the CA9 phylogenetic tree. Results Of the 100 patients with culture-proven CA9 infections, the mean (SD age was 4.6 (3.4 years and the male to female ratio was 1.9. For clinical manifestations, 96 patients (96% had fever and the mean (SD duration of fever was 5.9 (3.4 days. Sixty one patients (61% developed a skin rash, and the predominant pattern was a generalized non-itchy maculopapular rash without vesicular changes. While most patients showed injected throat, oral ulcers were found in only 19 cases (19%, among whom, 6 were diagnosed as herpangina. Complicated cases included: aseptic meningitis (n=8, bronchopneumonia (n=6, acute cerebellitis (n=1, and polio-like syndrome (n=1. Phylogenetic analysis for current CA9 strains is closest to the CA9 isolate 27-YN-2008 from the border area of mainland China and Myanmar. Conclusions The most common feature of CA9 during the 2011 epidemic in Taiwan is generalized febrile exanthema rather than herpangina or hand, foot, and mouth disease. Given that prolonged fever and some complications are possible, caution should be advised in assessing patients as well as in predicting the clinical course.

  2. Clinical features and phylogenetic analysis of Coxsackievirus A9 in Northern Taiwan in 2011 (United States)


    Background Coxsackievirus A9 (CA9) was one of the most prevalent serotype of enteroviral infections in Taiwan in 2011. After several patient series were reported in the 1960s and 1970s, few studies have focused on the clinical manifestations of CA9 infections. Our study explores and deepens the current understanding of CA9. Methods We analyzed the clinical presentations of 100 culture-proven CA9-infected patients in 2011 by reviewing their medical records and depicted the CA9 phylogenetic tree. Results Of the 100 patients with culture-proven CA9 infections, the mean (SD) age was 4.6 (3.4) years and the male to female ratio was 1.9. For clinical manifestations, 96 patients (96%) had fever and the mean (SD) duration of fever was 5.9 (3.4) days. Sixty one patients (61%) developed a skin rash, and the predominant pattern was a generalized non-itchy maculopapular rash without vesicular changes. While most patients showed injected throat, oral ulcers were found in only 19 cases (19%), among whom, 6 were diagnosed as herpangina. Complicated cases included: aseptic meningitis (n=8), bronchopneumonia (n=6), acute cerebellitis (n=1), and polio-like syndrome (n=1). Phylogenetic analysis for current CA9 strains is closest to the CA9 isolate 27-YN-2008 from the border area of mainland China and Myanmar. Conclusions The most common feature of CA9 during the 2011 epidemic in Taiwan is generalized febrile exanthema rather than herpangina or hand, foot, and mouth disease. Given that prolonged fever and some complications are possible, caution should be advised in assessing patients as well as in predicting the clinical course. PMID:23347781

  3. Marcel Proust's diseases and doctors: the neurological story of a life. (United States)

    Bogousslavsky, Julien


    Marcel Proust (1871-1922), one of the greatest writers of all times, suffered from asthma beginning at age 9, in an era when the illness was considered a 'nervous' disorder belonging to what Beard, in 1870, called 'neurasthenia'. Proust's father, Adrien, was himself a professor of medicine (hygiene) who had met Charcot, and who contributed to neurology with studies on aphasia, stroke, hysteria, and neurasthenia - a condition about which he, along with Gilbert Ballet, published a book in 1897. Through his father, Proust met Edouard Brissaud, the co-founder of the Revue Neurologique in 1893, and, in 1896, the author of The Hygiene of the Asthmatics, with a foreword by Adrien Proust. Shortly after his mother's death in 1905, Proust contemplated admitting himself to a private hospital to reset his irregular sleep patterns and to improve his asthma. He hesitated in his choice of care between Jules Dejerine in Paris, Henry-Auguste Widmer at Valmont, and Paul Dubois in Bern. Finally, he decided to enter Paul Sollier's clinic, in Boulogne-sur-Seine, on the advice of Brissaud, and stayed there for 6 weeks in semi-isolation. Together with Babinski, Sollier was, at that time, considered the most gifted follower of Charcot. He was a forerunner of studies on emotional memory, which strongly influenced Proust. In Proust's opus magnum work In Search of Lost Time, 'involuntary memory' indeed forms the core mechanism of the entire novel, counterbalancing the decaying effects of time. A few years before his death from complicated bronchopneumonia at age 52, Proust became terrified of developing a stroke, like his mother and father, and he consulted with Joseph Babinski, who tried to reassure him. Proust's life followed an unusual neurological itinerary, which has been largely overlooked, but which is in fact critical for an understanding of his literary work.

  4. Clinical and laboratory profile of children with Cystic Fibrosis: Experience of a tertiary care center in Pakistan (United States)

    Aziz, Danish Abdul; Billoo, Abdul Gaffar; Qureshi, Ahad; Khalid, Misha; Kirmani, Salman


    Objective: To determine the clinical presentation, diagnostic investigations and laboratory workup done in admitted children with cystic fibrosis at Aga Khan University Hospital Karachi, Pakistan. Methods: This is athree years retrospective study from January 2013 to December 2015 conducted at The Aga Khan University Hospital Karachi Pakistan, enrolling admitted patient from birth to 15 years of either gender, diagnosed with CF on the basis of clinical features and positive sweat chloride test. Different clinical presentations were noted including initial presentations. Sweat chloride values more than 60mmol/L were labeled as positive and consistent with diagnosis of CF. Available Delta F-508 mutation analyses were noted. Relevant laboratory and radiological investigations including sputum culture and HR-CT chest findings were documented. Results were analyzed using SPSS version 20. Results: Total 43 children were selected according to the inclusion criteria. Chronic cough (69.76%) was the most common initial clinical presentation. Mean age at onset of symptoms was 14.41± 26.18 months and mean age at diagnosis was 47.20 ± 45.80 months Respiratory features were most common in our cohort including chronic productive cough (90.71%), recurrent bronchopneumonia (72.09%) and asthma like presentation (44.19%) with wheezing and cough. 86% patients presented with failure to thrive. Gastroenterological features including steatorrhea were seen in 55.81% patients and 44.19% patients had abdominal distension. Mean sweat chloride value in our population was 82.70± 22.74. Gene analysis for Delta F-508 was identified in 12 (27.90%) patients. Bronchiectatic pulmonary changes on HRCT were seen in 18 patients (41.86%). Pseudomonas grew in 12 patients (27.90%) in sputum cultures at the time of diagnosis. Conclusion: Respiratory presentations predominate in CF children followed by gastrointestinal features. Nearly half of our patient had bronchiectatic changes on CT scan chest and

  5. Caracterización del neonato con peso menor de 1 500 g asistido con ventilación mecánica Characterization of the neonate weighing less than 1 500 g assisted by mechanical ventilation

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    Yanett Sarmiento Portal


    Full Text Available INTRODUCCIÓN. Uno de cada tres nacidos vivos que ingresa en la terapia neonatal requiere ventilación mecánica. El objetivo de la presente investigación fue caracterizar los factores relacionados con la ventilación mecánica en los neonatos menores de 1500 g. MÉTODOS. Se realizó un estudio observacional, longitudinal, retrospectivo y descriptivo, en la Unidad de Cuidados Intensivos Neonatales del Hospital «Abel Santamaría» (Pinar del Rio, entre 2006 y 2007. Se estudiaron 40 recién nacidos con peso menor de 1500 g que fueron ventilados en dicho período. Las variables se analizaron mediante las pruebas de comparación de dos y k proporciones de grupos independientes, con un nivel de significación p INTRODUCTION: One of each three live births admitted in neonatal therapy require mechanical ventilation. The aim of present research was to characterize the factors related to mechanical ventilation in all neonates weighing less than 1500 g. METHODS: A observational, retrospective and descriptive study was conducted in neonatal Intensive Care Unit from the "Abel Santamaría" Hospital of Pinar del Río province between 2006 and 2007. Forty newborn babies weighing less 1500 g were studied, which required ventilation in such period. Variables were analyzed by two comparison tests and k ratio of independent groups with a significance level of p < 0, 05. RESULTS: There was a male sex predominance, the birth weight was of 1250-1500 g and gestational age was from 27-29, 6 weeks. The 60% of patients received prenatal steroids. The more frequent mother's background was the early breaking of membranes (37,5%. The more frequent cause for ventilation was the hyaline membrane disease (60%. There was a predominance of acquired bronchopneumonia in ventilated neonates during more than 96 hr (30%. Aerial blockade and intraventricular hemorrhage were the complications more related to a lower survival (57,1%. CONCLUSIONS: It is advisable to continue the

  6. Feasibility of full and rapid neuromuscular blockade recovery with sugammadex in myasthenia gravis patients undergoing surgery – a series of 117 cases

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    Vymazal T


    Full Text Available Tomas Vymazal,1 Martina Krecmerova,1 Vladimír Bicek,1 Robert Lischke2 1Department of Anaesthesiology and ICM, 2nd Faculty of Medicine, 23rd Surgical Department of 1st Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic Purpose: Myasthenia gravis (MG is an autoimmune disease interfering with neuromuscular transmission. Patients are at risk of postoperative residual curarization (PORC if nondepolarizing muscle relaxants are used. Clinically inapparent insufficient muscle strength may result in hypoventilation and postoperative bronchopneumonia. We describe a cohort of 117 cases in which sugammadex was used in MG patients undergoing surgery with muscle relaxation with rocuronium.Methods and patients: We anesthetized 117 patients with MG using rocuronium and sugammadex as neuromuscular blockade reversal agent. One hundred five patients underwent surgical thymectomy and 12 underwent cholecystectomy (five laparotomic and seven laparoscopic. We measured time from sugammadex administration to recovery and to extubation, using the TOF-Watch® (series of four consecutive electrical impulses [the train-of-four] >0.9. We tracked peripheral capillary oxygen saturation (SpO2 <95%, elevation of partial pressure of carbon dioxide (pCO2 >10% above baseline, number of reintubations within the first 48 hours, and number of pneumonias within 120 hours, postoperatively. Results were processed as average, minimum, and maximum values.Results: The period needed to reach train-of-four of 0.9 following sugammadex administration was on average 117 seconds (minimum of 105 seconds/maximum of 127 seconds and differed within deviation <10%. The time to extubation following sugammadex administration was on average 276 seconds (minimum of 251 seconds/maximum of 305 seconds and differed minimally among patients as well. We observed no SpO2 <95%, no pCO2 elevation >10% above a baseline, no emergent reintubation within the

  7. Avaliação da qualidade da informação sobre a causa básica de óbitos infantis no Rio Grande do Sul (Brasil Assessment of the quality of information on basic causes of infant death in Rio Grande do Sul (Brazil

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    Letícia C. Nobre


    Full Text Available A partir de dados coletados para um estudo de casos e controles sobre mortalidade infantil por doenças infecciosas e desnutrição realizado em Porto Alegre e Pelotas, RS (Brasil, comparou-se as causas de óbito constantes do atestado médico com as causas obtidas através de uma revisão detalhada, realizada pela equipe da investigação. Concluiu-se que as estatísticas oficiais não são fidedignas, tendo havido sobre-registro de broncopneumonias (CID 485X e de septicemias (CID 038.9, e sub-registro de gastroenterites (CID 009.1 e de mortes súbitas (CID 798.0. A concordância entre os atestados refeitos e os oficiais, em termos de grupos de causas de óbito, foi de apenas 27.9%.The validity of the official information on the causes of infant deaths was studied in the Brazilian cities of Porto Alegre and Pelotas in 1985. Using data collected for a population-based case-control study of infant mortality due to infectious diseases or malnutrition, a comparison was made between the causes of death reported on the death certificates and those obtained after a careful review of case-notes and a medical interview with the parents of the deceased infants. Official death certificates showed an excess of deaths attribute to bronchopneumonia (ICD 485X and septicemia (ICD 038.9, and an underestimation of the number of deaths due to diarrheal diseases (ICD 009.1 and of sudden infant deaths (ICD 798.0. The overall rate of agreement between official and revised certificates, in terms of groups of causes of death, was only 27.9%. Lower respiratory infections, which were the leading infectious cause of infant deaths according to official statistics, were superseded by diarrheal diseases after this revision.

  8. Amiloidose renal em cão Shar-Pei: Relato de Caso Renal amyloidosis in a Shar-Pei dog: A case report

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    J.L. Reis Jr.


    Full Text Available O presente relato descreve os achados clínicos e anatomopatológicos de um caso de amiloidose renal em um cão macho de nove anos da raça Shar-Pei. O animal apresentava quadro clínico de esporotricose e de insuficiência renal e exames positivos para erlichiose e leishmaniose. No dia anterior ao óbito, o cão apresentou apatia, desidratação e anúria. À necropsia foram observados inúmeros pontos milimétricos esbranquiçados localizados no córtex renal e hepatização do lobo diafragmático esquerdo. O achado histológico mais importante foi deposição de material eosinofílico, amorfo e acelular localizado nos tufos glomerulares que se corou positivamente pelo vermelho congo (amilóide. Observaram-se nefrite supurada multifocal, espessamento da cápsula de Bowman e broncopneumonia supurada crônica, com fibrose intensa. A origem da amiloidose, no presente caso, poderia ser hereditária, assemelhando-se à amiloidose familiar descrita em cães da raça Shar-Pei, ou ser devida à inflamação supurada crônica e/ou leishmaniose.The clinical and pathological findings of a case of renal amyloidosis in a nine-year-old male Shar-Pei dog were described. Clinically, there were signs of sporotrichosis and renal insufficiency, besides being positive to leishmaniasis and ehrlichiosis. On the day before death, the animal became apathetic, dehydrated and anuric. On gross examination, there were several whitish millimetric spots seen widespread in both renal cortices and consolidation of the left diaphragmatic pulmonary lobe. The most important microscopic finding was a deposition of amorphous acellular material on the glomerular tufts which stained positively by congo red stain. Other changes were multifocal suppurative nephritis, thickening of the Bowman capsule and chronic suppurative bronchopneumonia. The origin of the amyloidosis in this case could be hereditary, being similar to familiar amyloidosis described in Shar-Pei breed, or due to

  9. Bovine viral diarrhoea, bovine herpesvirus and parainfluenza-3 virus infection in three cattle herds in Egypt in 2000. (United States)

    Aly, N M; Shehab, G G; Abd el-Rahim, I H A


    This study reported field outbreaks of bovine viral diarrhoea virus (BVDV) infection, either alone or mixed with bovine herpesvirus-1 (BHV-1) and/or parainfluenza-3 virus (PI-3V) in Egypt during 2000. In Lower Egypt, young calves in three cattle herds in El-Minufiya Province, El-Fayoum Province and in governmental quarantine in El-Behira Province, showed symptoms of enteritis, either alone or accompanied by respiratory manifestations. The affected herds were visited and the diseased animals were clinically examined. Many epidemiological aspects, such as morbidities, mortalities and case fatalities, as well as the abortive rate, were calculated. Ethylenediamine tetra-acetic acid-blood samples, sterile nasal swabs and serum samples were obtained for virological and serological diagnosis. The laboratory investigations revealed that the main cause of calf mortalities in the three herds was infection with BVDV, either alone, as on the El-Minufiya farm, or mixed with PI-3V, as on the El-Fayoum farm, or mixed with both BHV-1 and PI-3V, as in the herd in governmental quarantine in El-Behira Province. A total of nine dead calves from the three herds were submitted for thorough post-mortem examination. Tissue samples from recently dead calves were obtained for immunohistochemical and histopathological studies. The most prominent histopathological findings were massive degeneration, necrosis and erosions of the lining epithelium of the alimentary tract. Most of the lymphoreticular organs were depleted of lymphocytes. In pneumonic cases, bronchopneumonia and atypical interstitial pneumonia were evident. The present study suggested that the immunosuppressive effect of BVDV had predisposed the animals to secondary infection with BHV-1 and PI-3V. This study concluded that concurrent infection with BVDV, BHV-1 and PI-3V should be considered as one of the infectious causes of pneumoenteritis and, subsequently, the high morbidities and mortalities among young calves in Egypt

  10. Correlação diagnóstica anatomoclínica. Aferição retrospectiva do diagnóstico clínico em necrópsias Correlation between anatomo-clinical diagnosis and retrospective assessment of clinical diagnosis in post mortms

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    Marcos Célio de Almeida


    Full Text Available Analisaram-se retrospectivamente 200 necrópsias, correlacionando-se os diagnósticos clínicos e anatomopatológicos. Foram consideradas 20 entidades nosológicas para confronto. Os diagnósticos não formulados em vida, embora observados na necrópsia (falso negativo, e que apresentaram os maiores percentuais em relação aos respectivos totais de achados necroscópicos, foram: pielonefrite aguda (100%, embolia pulmonar (87,50%, aneurisma dissecante da aorta (66,66% e broncopneumonia (58,16%. Os diagnósticos formulados em vida que não tiveram confirmação pela necrópsia (falso positivo, e que apresentaram os maiores percentuais em relação aos respectivos totais dos diagnósticos clínicos, foram: tuberculose (69,50%, paracoccidioidomicose (57,14%, septicemia (53,13% e doença de Chagas (44,44%. Houve concordância diagnóstica em 97 (48,50% dos 200 casos. Em 19 (9,50% deles o desacordo diagnóstico, se antes verificado, poderia ter implicado alterações do prognóstico. Enfatiza-se a importância da necrópsia para uma adequada correlação anatomoclínica e discute-se os achados em relação a estudos prévios.The post mortem findings in 200 autopsies were compared with the clinical diagnoses. Twenty diseases were analysed with respect to clinico-pathological correlation. In relation to the respective totals the diseases most frequently missed clinically were (false negative pyelonephrites (100%, pulmonary embolus (87.50% and bronchopneumonia (58.16%. In relation to the respective totals the clinical diagnoses less frequently confirmed (false positive were tuberculosis (69.56%, paracoccidioidomycosis (57.14%, sepsis (53.13% and Chagas'disease (44.44%. There was clinico-pathological agreement in 97 autopsies (48.50%. In 19 cases (9.50% if the diagnostic error had been detected during life this probably would have changes the prognosis. The findings are discussed in the light of previous studies. The importance of routine post

  11. Clinical and molecular investigation of a canine distemper outbreak and vector-borne infections in a group of rescue dogs imported from Hungary to Switzerland. (United States)

    Willi, Barbara; Spiri, Andrea M; Meli, Marina L; Grimm, Felix; Beatrice, Laura; Riond, Barbara; Bley, Tim; Jordi, Rolf; Dennler, Matthias; Hofmann-Lehmann, Regina


    Canine distemper virus (CDV) is a major pathogen of dogs and wild carnivores worldwide. In Switzerland, distemper in domestic dogs is rarely reported. In recent years, the import of dogs from Eastern Europe to Switzerland has steadily increased. In the present study, we describe a distemper outbreak in 15 rescue dogs that were imported from Hungary to Switzerland by an animal welfare organisation. The data on vaccination and medical history were recorded (14 dogs), and the samples were collected to investigate CDV and vector-borne infections (13 dogs) and canine parvovirus infection (12 dogs). The dogs were monitored for six months. One dog was euthanised directly after import. Thirteen dogs showed clinical signs after arrival, i.e., diarrhoea (57 %), coughing (43 %) and nasal and/or ocular discharge (21 %); radiographic findings that were compatible with bronchopneumonia were present in four dogs. CDV infection was diagnosed in 11 dogs (85 %); 10 dogs (91 %) tested PCR-positive in conjunctival swabs. Vector-borne infections (Babesia spp., Leishmania infantum, Dirofilaria immitis) were found in 4 dogs (31 %). Three dogs were hospitalized, and six dogs received ambulatory therapy for up to two months until recovery. None of the dogs developed neurological disease. CDV shedding was detected for a period of up to four months. Because dogs were put under strict quarantine until CDV shedding ceased, CDV did not spread to any other dogs. The CDV isolates showed 99 % sequence identity in the HA gene among each other and belonged to the Arctic-like lineage of CDV. The present study highlights the imminent risks of spreading contagious viral and vector-borne infections through the non-selective import of sick dogs and dogs with incomplete vaccination from Eastern Europe. CDV shedding was detected for several months after the cessation of clinical signs, which emphasised the roles of asymptomatic carriers in CDV epidemiology. A long-term follow-up using sensitive PCR and

  12. Quadro epdiemiológico das mortes súbitas na infância em cidades gaúchas (Brasil Epidemiology of sudden infant deaths in cities of Rio Grande do Sul, Brazil. A comparative study of cases and controls

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    Cesar Gomes Victora


    , maternal smoking, and mixed or artificial feeding. None of the 72 deaths had been certified as such by the physicians who filled in the death certificates, the majority of which referred to "bronchopneumonia" as the undereying cause.

  13. Enfermedad ectasiante de la aorta abdominal: Morbilidad y mortalidad

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    Lilia E Chércoles Cazate


    Full Text Available Se presentó la experiencia de 10 años de trabajo (1983 a 1992, durante los cuales se atendieron 388 pacientes en el Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba, con el diagnóstico principal o asociado de aneurisma de la aorta abdominal. En el período analizado ingresaron en angiología y cirugía vascular 98 pacientes, 176 en medicina y 8 en otros servicios. Fallecieron a su llegada al cuerpo de guardia 106 por rotura del aneurisma o disección aórtica. Predominó el sexo masculino y la procedencia urbana. La hipertensión arterial fue la afección asociada más frecuente en los operados y la cardiopatía isquémica en los no operados. En los operados electivos, la complicación inmediata que más ocurrencia tuvo fue la trombosis de una rama de la prótesis y en los urgentes el sangramiento; mientras que en las mediatas, los operados electivos presentaron bronconeumonía y en los urgentes, anemia e íleo paralíticoThe experience of ten years of work (1983-1992 was presented. During that period, 388 patients with the main of associated diagnosis of abdominal aortic aneurysm were managed at the "Saturnino Lora" Provincial Educational Hospital, at Santiago de Cuba. In the decade analyzed, 98 patients entered in angiology and vascular surgery, 176 patients entered in medicine, and 8 in other services. In arriving to the emergency room, 106 subjects deceased due to aneurystic rupture or aortic dissection. Masculine sex and urban origin were prevailing. Arterial hypertension was the disease most frequently associated in the operated patients, and ischemic cardiac disease, among the non operated. In the elective operated patients, the immediate complication with the highest occurrence was the thrombosis of a branch of the prosthesis, and bleeding in the urgent cases, while in the mediate complications, the elective operated patients presented bronchopneumonia, and the urgent cases had anemia and paralytic ileus

  14. Ingesta oral do paciente hospitalizado com disfagia orofaríngea neurogênica Oral Intake of hospitalized patient with neurogenic oropharyngeal dysphagia

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    Carolina Castelli Silvério


    Full Text Available OBJETIVO: verificar a evolução na ingesta oral e a ocorrência de broncopneumonias (BCP em pacientes hospitalizados com disfagia orofaríngea neurogênica, após atuação fonoaudiológica. MÉTODOS: 50 pacientes adultos, divididos em grupos: I: 31 pacientes pós-acidente vascular encefálico; II: sete pacientes pós-traumatismo crânio-encefálico; III: 12 pacientes com demência. Foram levantadas as informações antes e após a atuação fonoaudiológica: nível da Functional Oral Intake Scale (FOIS, ocorrência de BCP; número de atendimentos fonoaudiológicos e motivo de interrupção destes. RESULTADOS: houve aumento significativo dos níveis da escala FOIS e redução do percentual de ocorrência de BCP nos três grupos estudados. Nos grupos pós-AVE e demência a interrupção da fonoterapia ocorreu devido à alta hospitalar, enquanto que no grupo pós-TCE devido à alta fonoaudiológica. CONCLUSÃO: os pacientes deste estudo demonstraram avançar das consistências alimentares na ingesta oral, e redução da ocorrência de BCP, após a intervenção fonoaudiológica com relação à disfagia.PURPOSE: to investigate the development in oral intake and the incidence of bronchopneumonia (BCP in hospitalized patients with neurogenic oropharyngeal dysphagia, after speech and language therapy intervention. METHODS: 50 adult patients, divided in three groups: I: 31 post stroke patients; II: seven brain injury patients ; III: 12 dementia patients. Data collected before and after the speech and language therapy intervention were: staff classification in Functional Oral Intake Scale (FOIS, incidence of BCP, number of therapies and reason for their interruption. RESULTS: significant increase in the levels of FOIS scale and reduction in incidence of pneumonia in the three studied groups. In the post stroke and dementia groups the reason for therapy interruption was hospital discharge, and in the group of brain injury the reason was speech and

  15. Defining syndromes using cattle meat inspection data for syndromic surveillance purposes: a statistical approach with the 2005–2010 data from ten French slaughterhouses (United States)


    Background The slaughterhouse is a central processing point for food animals and thus a source of both demographic data (age, breed, sex) and health-related data (reason for condemnation and condemned portions) that are not available through other sources. Using these data for syndromic surveillance is therefore tempting. However many possible reasons for condemnation and condemned portions exist, making the definition of relevant syndromes challenging. The objective of this study was to determine a typology of cattle with at least one portion of the carcass condemned in order to define syndromes. Multiple factor analysis (MFA) in combination with clustering methods was performed using both health-related data and demographic data. Results Analyses were performed on 381,186 cattle with at least one portion of the carcass condemned among the 1,937,917 cattle slaughtered in ten French abattoirs. Results of the MFA and clustering methods led to 12 clusters considered as stable according to year of slaughter and slaughterhouse. One cluster was specific to a disease of public health importance (cysticercosis). Two clusters were linked to the slaughtering process (fecal contamination of heart or lungs and deterioration lesions). Two clusters respectively characterized by chronic liver lesions and chronic peritonitis could be linked to diseases of economic importance to farmers. Three clusters could be linked respectively to reticulo-pericarditis, fatty liver syndrome and farmer’s lung syndrome, which are related to both diseases of economic importance to farmers and herd management issues. Three clusters respectively characterized by arthritis, myopathy and Dark Firm Dry (DFD) meat could notably be linked to animal welfare issues. Finally, one cluster, characterized by bronchopneumonia, could be linked to both animal health and herd management issues. Conclusion The statistical approach of combining multiple factor analysis with cluster analysis showed its relevance

  16. Defining syndromes using cattle meat inspection data for syndromic surveillance purposes: a statistical approach with the 2005-2010 data from ten French slaughterhouses. (United States)

    Dupuy, Céline; Morignat, Eric; Maugey, Xavier; Vinard, Jean-Luc; Hendrikx, Pascal; Ducrot, Christian; Calavas, Didier; Gay, Emilie


    The slaughterhouse is a central processing point for food animals and thus a source of both demographic data (age, breed, sex) and health-related data (reason for condemnation and condemned portions) that are not available through other sources. Using these data for syndromic surveillance is therefore tempting. However many possible reasons for condemnation and condemned portions exist, making the definition of relevant syndromes challenging.The objective of this study was to determine a typology of cattle with at least one portion of the carcass condemned in order to define syndromes. Multiple factor analysis (MFA) in combination with clustering methods was performed using both health-related data and demographic data. Analyses were performed on 381,186 cattle with at least one portion of the carcass condemned among the 1,937,917 cattle slaughtered in ten French abattoirs. Results of the MFA and clustering methods led to 12 clusters considered as stable according to year of slaughter and slaughterhouse. One cluster was specific to a disease of public health importance (cysticercosis). Two clusters were linked to the slaughtering process (fecal contamination of heart or lungs and deterioration lesions). Two clusters respectively characterized by chronic liver lesions and chronic peritonitis could be linked to diseases of economic importance to farmers. Three clusters could be linked respectively to reticulo-pericarditis, fatty liver syndrome and farmer's lung syndrome, which are related to both diseases of economic importance to farmers and herd management issues. Three clusters respectively characterized by arthritis, myopathy and Dark Firm Dry (DFD) meat could notably be linked to animal welfare issues. Finally, one cluster, characterized by bronchopneumonia, could be linked to both animal health and herd management issues. The statistical approach of combining multiple factor analysis with cluster analysis showed its relevance for the detection of syndromes

  17. Clinical efficacy of meloxicam (Metacam) and flunixin (Finadyne) as adjuncts to antibacterial treatment of respiratory disease in fattening cattle. (United States)

    Friton, Gabriele M; Cajal, Carlos; Ramirez Romero, Rafael; Kleemann, Rainer


    The clinical efficacy of two non-steroidal anti-inflammatory drugs (NSAIDs), meloxicam (Metacam 20 mg/ml) and flunixin meglumine (Finadyne), as adjuncts to antibacterial therapy in the treatment of acute febrile respiratory disease in cattle was compared. The randomised blind, positive controlled study was conducted under feedlot conditions in Mexico. Overall, 201 female cattle (weighing 220-250 kg) diagnosed with bronchopneumonia at the feedlot were recruited into the study. On Day 0 all animals were treated with 20 mg oxytetracycline/kg body-weight (Bivatop 200) by subcutaneous injection, in conjunction with either meloxicam (0.5 mg/kg subcutaneously, Metacam 20 mg/ml, n = 100), or flunixin meglumine (2.2 mg/kg intravenously, Finadyne, n = 101). According to label instructions, meloxicam was administered as a single dose, whereas flunixin meglumine could be administered daily for up to 3 consecutive days depending on the rectal temperature (with re-administration, if rectal temperature > or = 40.0 degrees C). Rectal temperature, respiratory rate, appetite, dyspnoea, coughing, nasal discharge and general condition were recorded on Days 0 (prior to treatment), 1, 2, 3 and 7 using a weighted numerical score. Scores were summed to generate a 'Clinical Sum Score' (CSS, range 7 to 24 points). Individual animal body weights were measured on Days 0 and 7. Nasal swabs were collected from 10 animals per treatment group on Day 0 for microbiological culture. Clinical parameters and the mean CSS showed no significant differences between treatment groups with mean CSS on Days 0 and 7 of 16.18 and 10.55 in the meloxicam group and 16.41 and 10.88 in the flunixin meglumine group. However, a significantly lower mean rectal temperature was measured in the meloxicam group on Day 2 (p flunixin meglumine was performed in 45% of the animals. No suspected adverse drug events related to treatments were reported. It is concluded that a single subcutaneous dose of meloxicam was as

  18. Influence of Plasmid Type on the Replication of Rhodococcus equi in Host Macrophages. (United States)

    Willingham-Lane, Jennifer M; Berghaus, Londa J; Giguère, Steeve; Hondalus, Mary K


    The soil-dwelling, saprophytic actinomycete Rhodococcus equi is a multihost, facultative intracellular pathogen of macrophages. When inhaled by susceptible foals, it causes severe bronchopneumonia. It is also a pathogen of pigs, which may develop submaxillary lymphadenitis upon exposure. R. equi isolates obtained from foals and pigs possess conjugative plasmids housing a pathogenicity island (PAI) containing a novel family of genes of unknown function called the virulence-associated protein or vap family. The PAI regions of the equine and swine plasmids differ in vap gene composition, with equine isolates possessing six vap genes, including the major virulence determinant vapA, while the PAIs of swine isolates house vapB and five other unique vap genes. Possession of the pVAPA-type virulence plasmid by equine isolates bestows the capacity for intramacrophage replication essential for disease development in vivo. Swine isolates of R. equi are largely unstudied. Here, we show that R. equi isolates from pigs, carrying pVAPB-type plasmids, are able to replicate in a plasmid-dependent manner in macrophages obtained from a variety of species (murine, swine, and equine) and anatomical locations. Similarly, equine isolates carrying pVAPA-type plasmids are capable of replication in swine macrophages. Plasmid swapping between equine and swine strains through conjugation did not alter the intracellular replication capacity of the parental strain, indicating that coevolution of the plasmid and chromosome is not crucial for this attribute. These results demonstrate that while distinct plasmid types exist among R. equi isolates obtained from equine and swine sources, this tropism is not determined by host species-specific intramacrophage replication capabilities. IMPORTANCE This work greatly advances our understanding of the opportunistic pathogen Rhodococcus equi, a disease agent of animals and immunocompromised people. Clinical isolates from diseased foals carry a

  19. Pharyngeal cancer prevention: evidence from a case--control study involving 232 consecutive patients. (United States)

    Escribano Uzcudun, Ana; Rabanal Retolaza, Ignacio; García Grande, Antonio; Miralles Olivar, Lara; García García, Alfredo; González Barón, Manuel; Gavilán Bouzas, Javier


    The aim of this study was to determine risk factors for pharyngeal cancer and to propose 10 result-based preventive measures. It was a case-control study conducted in Madrid, Spain, with 232 consecutive patients diagnosed between January 1 1990 and December 31, 1995, sex- and age-matched with 232 control individuals with no oncological disease or history. By means of an interviewer-administered questionnaire, seven different epidemiological areas were surveyed, namely: (1) sociodemographic variables, (2) familial all-site cancer history, (3) medical history, (4) lifestyle (habits), (5) diet, (6) occupational exposure, and (7) non-occupational exposure. Of the great number of factors within each epidemiological area, the following were found to be risk factors after adjustment for tobacco smoking and alcoholic beverage drinking: (1) tobacco smoking, (2) alcoholic beverage drinking, (3) low and low-middle socioeconomic background, (4) low educational level, (5) rural milieu, (6) working, or having worked, as a manual worker in agriculture, (7) working, or having worked as a manual worker in building industry, (8) having an upper aerodigestive tract cancer familial history, (9) having a medical history of alcholism, low weight/malnutrition, gastroesophageal reflux or chronic obstructive bronchopneumonia, (10) low dietary intake of fruit, fruit juice, uncooked vegetables, dietary fibre-containing foods, fish and milk and dairy products, (11) high dietary intake of meat and fried foods, (12) deficient oral and dental hygiene, (13) abuse of black coffee, (14) abuse of 'carajillo' (a typical Spanish drink composed of black coffee and flambéed brandy), (15) occupational exposure to pesticides, solvents and dust of different origins. On the basis of our results and those reported by other authors, we put forward 10 measures for the prevention of pharyngeal cancer. However, due to the small size of the nasopharyngeal cancer subsample (n = 35, 15.08 per cent), our results as

  20. Tratamiento con azlocillin y amikacina en sepsis neonatal por staphylococcus haemolyticus multirresistente

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    María Espino Hernández


    Full Text Available El estafilococo coagulasa negativa es actualmente un importante patógeno nosocomial y agente causal de infección en el neonato. Cepas multirresistentes comúnmente aisladas de recién nacidos sometidos a cuidados intensivos dificultan la terapéutica, por lo que se hace necesario el empleo de combinaciones antibióticas que garanticen un efecto antibacteriano más eficiente. Se presentan los resultados obtenidos en un paciente con bronconeumonía adquirida por Staphylococcus haemolyticus multirresistente y que fue sometido a tratamiento combinado de azlocillin y amikacina. Se estudió el patrón de resistencia de la cepa para 30 antibióticos por métodos de difusión y dilución, así como la efectividad in vitro de la combinación antibiótica aplicada por el método del «tablero de ajedrez». Se observó en los resultados in vitro una marcada potencialización de la actividad aminoglucosídica por la presencia del antibiótico beta-lactámico, resultado que se correspondió con una excelente respuesta in vivo.Negative-coagulase Staphyloccocus, is at present time an important nosocomial pathogen and a causal agent of neonatal infection. Multirresistant strains commonly isolated from newborn under intensive care, make difficult treatment, so it is necessary use of antibiotic combination to assure a more efficient antibacterial effect. We present results obtained in a patient presenting with acquired bronchopneumonia from multirresistant Staphylococcus haemolyticus who received a combination of Azlocillin and Amikacin. Resistance pattern to this strain was studied by diffusion and dilution methods, as well as in vitro effectiveness of antibiotic combination, applied by "Chequerboard" method. In in vitro results, we found a significant potentiation of aminoglucoside activity by presence of Beta-lactamic antibiotic, result corresponding to an in vivo excellent response.

  1. Histopathological and immunohistochemical findings of swine with spontaneous influenza A infection in Brazil, 2009-2010

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    Tatiane T.N. Watanabe


    Full Text Available Swine influenza (SI is caused by the type A swine influenza virus (SIV. It is a highly contagious disease with a rapid course and recovery. The major clinical signs and symptoms are cough, fever, anorexia and poor performance. The disease has been associated with other co-infections in many countries, but not in Brazil, where, however, the first outbreak has been reported in 2011. The main aim of this study was to characterize the histological features in association with the immunohistochemical (IHC results for influenza A (IA, porcine circovirus type 2 (PCV2 and porcine reproductive and respiratory syndrome virus (PRRSV in lung samples from 60 pigs submitted to Setor de Patologia Veterinária at the Universidade Federal do Rio Grande do Sul (SPV-UFRGS, Brazil, during 2009-2010. All of these lung samples had changes characterized by interstitial pneumonia with necrotizing bronchiolitis, never observed previously in the evaluation of swine lungs in our laboratory routine. Pigs in this study had showed clinical signs of a respiratory infection. Swine samples originated from Rio Grande do Sul 31 (52%, Santa Catarina 14 (23%, Paraná 11 (18%, and Mato Grosso do Sul 4 (7%. Positive anti-IA IHC labelling was observed in 45% of the cases, which were associated with necrotizing bronchiolitis, atelectasis, purulent bronchopneumonia and hyperemia. Moreover, type II pneumocyte hyperplasia, alveolar and bronchiolar polyp-like structures, bronchus-associated lymphoid tissue (BALT hyperplasia and pleuritis were the significant features in negative anti-IA IHC, which were also associated with chronic lesions. There were only two cases with positive anti-PCV2 IHC and none to PRRSV. Therefore, SIV was the predominant infectious agent in the lung samples studied. The viral antigen is often absent due to the rapid progress of SI, which may explain the negative IHC results for IA (55%; therefore, IHC should be performed at the beginning of the disease. This study

  2. Plague and other human infections caused by Yersinia species. (United States)

    Putzker, M; Sauer, H; Sobe, D


    With an estimated 100 million victims, pandemically and epidemically occurring plague has been looked upon as a classical scourge of mankind during the last two millenia. Without treatment at least 50% of the affected individuals die from infection with Yersinia pestis, a bacterium belonging to the family of Enterobacteriaceae. The disease takes a fulminant course. After an incubation period of 2-6 days, bubonic plague primarily attacks one group of lymph nodes. The onset of pulmonic plague, transmitted by droplet infection, takes place within several hours and causes bronchopneumonia. Early recognition facilitates a promising antibiotic therapy with tetracycline, streptomycin or chloramphenicol. Human beings acquire the bacteria through bites of fleas from domestic rats in densely populated cities of countries with low hygienic standards, or sporadically in the open country from infected wild rodents. Laboratory procedure includes microscopy supplemented by immunofluorescence and cultivation of the bacterium from clinical material. Direct serology and PCR result in a fast detection of specific antigens or nucleotide sequences. Determination of serum antibodies is principally used for epidemiological investigation. Today, physicians in the civilized western world lack experience for the recognition of plague, and analytical techniques for diagnosis are only available in some specialized laboratories. Yersiniosis becomes primarily manifest as gastroenteritis caused by Yersinia enterocolitica or as pseudoappendicitis caused by Yersinia pseudotuberculosis and requires antibiotics only in severe septic cases. Different extraintestinal symptoms may be observed in dependence on the patient's HLA type and gender. The ubiquitous germ is mainly transmitted by the fecal-oral route via infected domestic or farm animals and contaminated food. The relevant virulence factors are encoded on a 70 kB plasmid common to all Yersinia species and strains that are human pathogens. The

  3. Óbitos em instituição asilar Deaths in nursing homes

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    Milton Luiz Gorzoni


    analysis. The collected data were gender, age, cause(s of death and underlying disease(s. The statistical analysis compared data between the two genders and two age ranges ( 75 years. RESULTS: There were 118 deaths in 2006 (mean age: 74.5 ± 15.2 years - 64 women (mean age: 78.4 ± 14.4 years old and 54 men (mean age: 69.8 ± 15.0 years old. Causes of death were sepsis (41 deaths, septic shock (25, bronchopneumonia (16, sudden death (11, multiple-organ failure (9 and other causes (16 deaths. The main underlying diseases were infections (63 deaths - bronchopneumonia (34, sepsis (12, urinary tract infection (7 infected pressure ulcers (7, osteomyelitis (2 and bile duct infection (1; immobility syndrome (42 deaths. The proportion of women older than 75 years showed statistical significance concerning the number of deaths. The sample did not show statistical significance regarding seasonality, causes of death or underlying disease(s when comparing infectious and noninfectious causes of death vs. men and women, aged older or younger than 75 years. CONCLUSION: Deaths in nursing homes were basically caused by a combination of immobility and infections that developed into sepsis.

  4. Repouso da junção neuromuscular no tratamento de crises miastênicas e colinérgicas Management of the myasthenic and cholinergic crisis by neuromuscular junction rest

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    J. Lamartine de Assis


    second group, in addition to this management, were submitted to prolonged curarization by galamine (Flaxedil by intramuscular injection; all of them presented an initial curare supersensitivity which always decreased shortly. In both methods the reinstitution of the drug therapy was progressive. The respirator weanned of progressively and the patients were kept under observation for adequate ventilation. The doses were variable but subsequent doses of antimyasthenic medications were determined by clinical findings and response to the tensilon or prostigmine tests. The doses were increased or decreased accordingly in each individual case, rapid changes of drug doses to perfect adjustment being undesirable in this transition period. Partial or temporary remission occurred in some patients. Others were able to sustain satisfactory ventilation for a long period or definitively. Most of the crisis improved and most of the patients benefited from the therapeutic method of the neuromuscular junction rest. There was a remarkable reduction in the mortality rate from the crisis. One patient had a thymoma which was malignant; in spite of this the evolution of this case has been good after the treatment. Those patients who had immediate good response to the treatment of the crisis had a favorable fellow up, even a complete remission. Respiratory infections were very common in spite of all cares. Culture of tracheal secretions and wound exsudates were made. Bactericidal and broad-spectrum antibiotics were used, depending of the laboratory report cf patient's sensitivity. Physiotherapy besides other prophylactic measures was used against bronchopneumonia. Atelectasis was a common complication in the crisis and all efforts to prevent it were made, including daily clinical examination of pulmonary conditions, Vt,, blood pressure and bed side chest films. The routine use of atropine sulfate promoved inspissation of bronchial secretions, plugging of the bronchi, and attendant atelectasis

  5. Indicadores da evolução do paciente com paralisia cerebral e disfagia orofaríngea após intervenção terapêutica Evolution indicators of patients with cerebral palsy and oropharyngeal dysphagia after therapeutic intervention

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    Carolina Castelli Silvério


    Full Text Available OBJETIVO: Verificar a evolução na função de alimentação e estabilidade clínica de crianças com paralisia cerebral tetraparética espástica após intervenção terapêutica. MÉTODOS: Foram levantados em prontuário médico, antes e após a terapia, os dados de classificação da funcionalidade da alimentação (escala FOIS e grau de disfagia, consistências alimentares e sinais sugestivos de penetração e/ou aspiração laringotraqueal de 36 crianças com paralisia cerebral espástica. RESULTADOS: A maioria dos sujeitos alimentava-se com preparo especial, antes e após a intervenção, ocorrendo restrição de sólidos e líquidos no segundo momento. Houve diminuição da severidade da disfagia, redução de broncopneumonias e hipersecretividade pulmonar, aumento do peso e diminuição dos sinais sugestivos de penetração e/ou aspiração laringotraqueal, exceto recusa alimentar e cianose. CONCLUSÃO: A intervenção fonoaudiológica, em conjunto com a equipe multidisciplinar em disfagia, promove maior funcionalidade da deglutição e diminuição dos sinais sugestivos de penetração e/ou aspiração traqueal, além de maior estabilidade clínica.PURPOSE: To verify the evolution in nutrition and clinical stability of children with spastic tetraparetic cerebral palsy, after therapeutic intervention. METHODS: Data from before and after the therapeutic process were raised from the medical records of 36 children with spastic cerebral palsy, regarding classification of functional oral intake (FOIS scale and degree of dysphagia, food consistency, and suggestive signs of penetration and/or tracheal aspiration. RESULTS: Most subjects were fed with special preparation, before and after intervention, with restrictions to solid and liquid foods in the second instance. It was observed decrease of the severity of dysphagia, reduction of the incidence of bronchopneumonia and pulmonary hypersecretion, weight increase, and reduction of suggestive

  6. Causas de muerte en pacientes diabéticos de Ciudad de La Habana según certificados de defunción Causes of death in diabetic patients from Havana City according to death certificates

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    Ernesto Rosales González


    Full Text Available Fueron revisados 17 936 certificados de defunción de fallecidos en Ciudad de La Habana durante el año 2002, de los cuales 1 202 correspondieron a diabéticos fallecidos en ese período. Estos certificados se encuentran en poder de la Dirección Nacional de Estadísticas del MINSAP en Ciudad de La Habana. De los 1 202 fallecidos, 438 pertenecen al grupo causa básica, y de ellos 257 (58,72 % pertenecen al sexo femenino y 181 (41,32 % al sexo masculino, el grupo de edades más afectado fue el de 70 a 79 años (28,52 %, seguido por el de 60-69 años (26,32 %. El grupo hallazgos con 764 diabéticos fallecidos no será objeto de estudio en este trabajo. La causa más frecuente en el grupo causa básica fueron la bronconeumonía, el infarto miocárdico agudo, la insuficiencia renal y la sepsis. Constituye una preocupación el avance de la insuficiencia renal como causa directa de muerte. El trastorno metabólico, aunque no constituye una de las cinco primeras causas de muerte, sí reportó 12 fallecidos por cetoacidosis (tasa 0,5, seguido por el coma hipoglicémico y el hiperosmolar, lo que puede evidenciar fallos en la atención primaria y secundaria. El infarto miocárdico agudo fue la causa de muerte más frecuente en los fallecidos en el domicilio según certificados.17 936 death certificates of persons who died in Havana City during 2002 were reviewed. Of them, 1 202 corresponded to diabetics. These certificates are in the National Statistics Division of the Ministry of Public Health, in Havana City. Of the 1 200 dead, 438 belonged to the basic cause group, and of them 257 (58.72 % are females and 181 (41.32 % are males. The age group 70-79 was the most affected (28.52 %, followed by those aged 60-69 (26.32 %. The findings group with 764 dead diabetics will not be object of study in this paper. The most commom causes in the basic cause group were bronchopneumonia, acute myocardial infarction, renal failure and sepsis. The progress of renal

  7. Melioidosis in Malaysia: A Review of Case Reports. (United States)

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini


    Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. We sought to review case reports of melioidosis from Malaysia. We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common-genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among

  8. Toward a standardized investigation protocol in sudden unexpected deaths in infancy in South Africa: a multicenter study of medico-legal investigation procedures and outcomes. (United States)

    du Toit-Prinsloo, Lorraine; Dempers, Johan; Verster, Janette; Hattingh, Christa; Nel, Hestelle; Brandt, V D; Jordaan, Joyce; Saayman, Gert


    done in a total of 14 (0.5 %) cases. Discrepancies were present in the extent of the macroscopic post-mortem examinations, as well as the type and extent of the ancillary investigations performed. The investigations were completed in 2,583 of the cases. The majority of these infants died from natural disease processes [1,976 infants (76.5 %)]. Bronchopneumonia was the leading cause of natural deaths at all the mortuaries [674 cases (26.1 %)]. SIDS was diagnosed in only 224 cases (8.7 %) and in 383 (14.8 %) cases, where a full post-mortem examination with ancillary investigations was conducted; the cause of death was recorded as "unascertained." This study indicated that the admission criteria (to medico-legal mortuaries) and the investigative process/protocols in cases of SUDI differ greatly among 5 of the largest academic medical institutions in South Africa. Establishing and implementing standardized admission criteria (to medico-legal mortuaries) and implementing uniform investigative and autopsy protocols would appear to be an essential prerequisite to gain better understanding of the mystery of SIDS in South Africa.

  9. Pathogenicity of Rhodococcus equi in mice, isolated from environment, human and horse clinical samples Patogenicidade atogenicidade em camundongos de isolados clí- clínicos, nicos, ambientais e humanos de Rhodococcus equi

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    Mateus M. Costa


    Full Text Available Rhodococcus equi is a facultative intracellular pathogen associated with bronchopneumonia, mesenteric lymphadenitis and enterocolitis in foals. Although R. equi is likely to be found in every horse-breeding farm, the clinical disease is unrecognized in most of them. Capsule components, equi factor, micolic acid and some products encoded by the large 85-90Kb plasmid were described as virulence factors. However, the pathogenesis of R. equi infections and the sensibility of foals are not completely understood. The aim of this study was evaluate the virulence of R. equi isolated from human, horses and environment for mices. Nine strains carrying the 85-90Kb plasmid isolated from foal clinical specimens, one from immunodeficient human patient and six plasmidless strains (four isolated from feces, one from pasture and one from immunodeficient human patient were inoculated in cyclophosphamide immunossuppressed mice. The pathological changes and viability of R. equi cells in the liver of mice was verified after the 3rd, 6th an 10th day after inoculation for horse and environmental isolates and for R. equi isolates from human patients on the 1st, 3rd and 6th day. During the necropsy procedures, infiltrate of macrophages and pyogranulomatous lesions were detected after the sixth pos-inoculation day in the liver and spleen. In horse isolates, only plasmid positive strains were virulent, but in human isolates both strains (plasmid positive e plasmid negative were virulent. Both groups of the immunossupressed mice inoculated with R. equi isolated from environment showed pathological changes. All R. equi strains were unable to kill non imunossuppressed mice.Rhodococ-cus equi é um patógeno intracelular facultativo associado com broncopneumonia, linfadenite mesentérica e enterocolite em potros. Apesar do patógeno ser amplamente distribuído no ambiente equino, a doença não é encontrada em todos os criatórios. Componentes capsulares, "fator equi",

  10. Acquired Ondine's curse: case report Maldição de Ondina adquirida: relato de caso

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    Pedro Schestatsky


    Full Text Available We report and discuss the case of a 55-year old man who presented a history of stroke as well as chronic obstructive pulmonary disease. When admitted into the emergency room, he was diagnosed with a vertebro-basilar syndrome. A brain MRI showed a hyperintense area in the lower right brainstem laterally within the medulla, which corresponds to the area of the pathways descending from the autonomic breathing control center. During hospitalization, the patient had several episodes of prolonged apnea, mainly when asleep, having often to be "reminded" to breath. A tracheostomy was then performed with the patient under mechanical ventilation. Treatment with medroxyprogesterone, fluoxetine and acetazolamide was also started. He was discharged after 64 days breathing environmental air with no apparent episodes of apnea. He returned to the emergency room in the following day with a clinical picture of aspiration bronchopneumonia, followed by septic shock and death. CONCLUSION: the Ondine's curse is one of the posterior stroke's presentation characterized by loss of automatic breathing and for the unpredictability of clinical evolution and prognosis. Such a syndrome has rarely been reported in adults and the diagnostic criteria are not consensual in the reviewed literature. Thus any dignostic confirmation should be flexible. There are many therapeutic symptomatic options in such cases, ranging from pharmacologic approach, use of bilevel positive airway pressure and implantation of diaphragmatic pacemaker.Relatamos e discutimos o caso de um paciente de 55 anos de idade que apresentara história de acidente vascular cerebral e doença broncopulmonar obstrutiva crônica. Quando admitido no setor de emergência, foi diagnosticado como vítima de síndrome vértebro-basilar. A ressonância magnética mostrou hiperintensidade no tronco inferior à direita ao nível do bulbo, o que corresponde a área das vias descendentes do centro do controle respirat

  11. Mortalidade infantil por causas no Estado de São Paulo (Brasil em 1983: análise sob a perspectiva das causas múltiplas de morte Infant mortality by causes in the State of S.Paulo (Brazil in 1983: analysis under the perspective of multiple causes of death

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    Paulo Murad Saad


    Full Text Available Objetivou-se apresentar a mortalidade infantil por causas no Estado de São Paulo, Brasil, com base nos dados de 1983 obtidos a partir da classificação por causas múltiplas de morte, disponíveis desde a implantação do Sistema de Classificação Automática de Causas de Morte. Detectaram-se dois tipos de casos bem definidos: os óbitos ocorridos predominantemente no período neonatal, e cujo processo mórbido envolve quase que exclusivamente as afecções pertencentes ao Capítulo das Perinatais da Classificação Internacional de Doenças; e os óbitos ocorridos principalmente no período pós-neonatal, em cujo processo mórbido aparecem mencionadas significativamente as infecções intestinais, a septicemia, a desnutrição, a desidratação e a broncopneumonia. O estudo da associação entre as principais causas de morte mostrou, por um lado, a imaturidade e a prematuridade fortemente relacionadas com as afecções respiratórias do recém-nascido e com as infecções específicas do período perinatal; e por outro lado, um complexo inter-relacionamento entre as outras cinco causas mencionadas.An analysis of child mortality by causes was made on the basis of classification by multiple causes of death. For this archives containing records of child deaths in the State of S.Paulo (Brazil for 1983 were used. The underlying cause and the associated causes, according to various clustering types, were, among other variables, retrieved from each record. Two types of cases with clearly determined characteristics were detected: those occurring predominantly during the neonatal period with the morbid process involving almost exclusively diseases in the Perinatal chapter (Chapter XV of the International Classification of Diseases, 9th Revision, and those occurring after the neonatal period with their morbid process showing a significant presence of intestinal infections, septicemia, malnutrition, dehydration and bronchopneumonia. An analysis of M

  12. Diagnostic pitfalls in a young Romanian ranger with an acute psychotic episode

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    Nagy EE


    battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin – for suspected aspiration bronchopneumonia – and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset, the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the basis of the putative occupational risk, acute psychotic episode, and the success of antibiotic therapy, we registered this case as a late neuroborreliosis with atypical appearance.Keywords: Borrelia burgdorferi, neuroborreliosis, neuropsychiatric symptoms, encephalitis, anti-NMDAR

  13. Tumores primarios de la pared torácica Primary tumors of the thorax wall

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    Bárbaro Agustín Armas Pérez


    conducted to analyze the results of surgical treatment in 22 patients (sample with primary tumors of the thorax wall during 15 years (from January,1993 to December, 2008 in the services of general surgery and orthopedics of the "Amalia Simoni" Hospital of the Camagüey province. Results: there was a slight predominance of female sex and the age group from 17 to 44 years (mean, 39.4, the predominant comorbid disease was the high blood pressure, the right hemithorax was the more involved and the ribs from 1 to 4 were the more injured with predominance of benign affections including the osteochondroma. The treatment more applied was the surgical resection and the postoperative complication predominant was the bronchopneumonia. The tumor relapse rate was high but not always due to cancer. The were 4 deceased due to advanced malignant disease without perioperative deaths. Conclusions: results were compared to other reports with coincidence points in different features but also differing and try to unify criteria to improve diagnosis y the results of treatment of these patients. Most of patients were without complications and the tumor relapse was over the expected. The tumor resection always must to be wide. Global result was satisfactory.

  14. Síndrome de Alagille Alagille syndrome

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    Yuri Betancourt Guerra


    Full Text Available El síndrome de Alagille es un trastorno genético cuya manifestación fundamental es una colestasis crónica producida por una hipoplasia de las vías biliares intrahepáticas, y se asocia a malformaciones congénitas cardiacas, renales y esqueléticas en pacientes con un fenotipo peculiar. Tiene una frecuencia de aparición de 1 por cada 100 000 nacidos vivos. La lesión histológica está dada por una reducción en la relación entre el número de conductos biliares y el de los espacios porta. Tiene una mortalidad global de un 20 %, y los pacientes pueden llegar a necesitar transplante hepático para su supervivencia. Se describe un paciente de 6 años de edad, femenina, que ingresa a los 23 días de nacida en el Hospital Pediátrico "Dr. Eduardo Agramonte Piña" por bronconeumonía, pero durante su estancia en el hospital se detecta síndrome colestásico dado por íctero y acolia, además de estenosis pulmonar y facies característica. Se realiza biopsia hepática compatible con síndrome de Alagille. El caso fue evaluado y se diagnostica la enfermedad por la presencia de criterios diagnósticos. Evoluciona de forma estable, con seguimiento por consulta externa hasta los 6 años, cuando ingresa en el Hospital Pediátrico "William Soler" para transplante hepático.Alagille syndrome is a genetic disorder and its main manifestation is chronic cholestasis caused by intrahepatic bile duct hypoplasia. It is associated with cardiac, renal and skeletal congenital malformations with peculiar phenotypes. It can occur in one per 100 000 livebirths. The histological lesions are caused by a reduction of the ratio of the number of bile ducts and the number of porta spaces. The global mortality rate of the disease is 20 % and the patients may need some hepatic transplantation for survival. Here is the case of a 6 years-old girl who was admitted to "Dr Eduardo Agramonte Piña" hospital when she was 23-days-old because she had bronchopneumonia, but during

  15. Efeito da continuidade da fisioterapia respiratória até a alta hospitalar na incidência de complicações pulmonares após esofagectomia por câncer Effect of sustained respiratory care until hospital discharge on the incidence of pulmonary complications following esophagectomy for cancer

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    Adriana Claudia Lunardi


    higher tobacco consumption than ICUg ones (35.7±17.6 vs 26.1±18.4 packs-year, p<0.05, there were 20% less pulmonary complications in this group when compared to the ICU group (10% vs 30%, p<0.05: lesser incidence (75% of pleural effusion and 50% less of bronchopneumonia. DISg also had undergone a shorter time (less 4.5 days with pleural drain on (p<0.05. These findings suggest chest physical therapy care all along hospital stay until discharge may reduce pulmonary complications after esophagectomy for cancer.

  16. Melioidosis in Malaysia: A Review of Case Reports.

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    Paul Vijay Kingsley


    Full Text Available Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis.We sought to review case reports of melioidosis from Malaysia.We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome.Overall, 67 cases were reported with 29 (43% deaths; the median age was 44 years, and a male preponderance (84% was noted. Forty-one cases (61% were bacteremic, and fatal septic shock occurred in 13 (19% within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54% was the most common risk factor. Twenty-six cases (39% had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36% was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%. Other types of clinical presentations were less common-genitourinary (n = 5, neurological (n = 5, osteomyelitis/septic arthritis (n = 4 and skin (n = 2; five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21% was the most common followed by liver (18%; abscesses of the spleen and lung were the third most common (12% each. Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among

  17. [Cytokine storm in avian influenza]. (United States)

    Us, Dürdal


    The most dramatic example of defining the pathogenicity of influenza virus A/H5N1 strains is the higher fatality rate of avian influenza epidemic (>50%) occured in Southeast Asia in 1997 comparing to the pandemic caused by influenza virus A/H1N1 in 1918 (5-10%) which was recorded as the most destructive pandemic in the world. When considering the fatal/total case numbers (208/340) reported by World Health Organization in respect of December 14th, 2007, the mortality rate has now reached to 61 percent. Recent studies have shown that the high fatality rate of avian influenza virus infections is a consequence of an overactive inflammatory response and the severity of infection is closely related with virus-induced cytokine dysregulation. The most important feature of A/H5N1 immunopathogenesis is the appearence of hypercytokinemia ("cytokine storm") which is characterized by the extreme (exaggerated) production and secretion of large numbers and excessive levels of pro-inflammatory cytokines. This phenomenon is blamed on the emergence of lethal clinical symptoms such as extensive pulmonary oedema, acute bronchopneumoniae, alveolar haemorrhage, reactive haemophagocytosis, and acute respiratory distress syndrome, associated with necrosis and tissue destruction. Numerous in vitro, in vivo and clinical studies have pointed out that A/H5N1 viruses are very strong inducers of various cytokines and chemokines [Tumor Necrosis Factor (TNF)-alpha, Interferon (IFN)-gamma, IFN-alpha/beta, Interleukin (IL)-6, IL-1, MIP-1 (Macrophage Inflammatory Protein), MIG (Monokine Induced by IFN-gamma), IP-10 (Interferon-gamma-Inducible Protein), MCP-1 (Monocyte Chemoattractant Protein), RANTES (Regulated on Activation Normal T-cell Expressed and Secreted), IL-8], in both humans and animals. The privileged cells of cytokine storm are macrophages and CD8+ T-lymphocytes, while the primary contributor cytokines are TNF-alpha, IL-6 and IFN-gamma. It has been detected that, mutations of some viral

  18. Tubo gástrico con conservación anatómica y funcional del píloro Gastric tube with anatomical and functional conservation of the pylorus

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    Albio Ferrá Betancourt


    result obtained in patients who underwent subtotal esophagectomy and replacement of the organ by tubulised stomach without applying gastric drainage (pyroloplasty. METHODS. 16 patients treated with this procedure from January 2002 to September 2005 were analyzed. The studied variables were the surgical technique used, the postoperative complications and the presence of symptoms. RESULTS. The resection by McKeown's technique was performed in 50 % of the cases, whereas the transhiatal access was carried out in 43.8 % and Ivor Lewis' technique in 6.2 %. Seven patients (43.8 % suffered complications, mainly due to esophagogastric cervical fistula (6 cases. The last of them presented atelactasia and bilateral bronchopneumonia that caused his death. At the six months of follow-up, there were neither symptoms of alkaline reflux nor of difficulty to evacuate the stomach. CONCLUSIONS. The presence of gastric retention or duodenogastric reflux was not proved in this study. However, it is recommendable to conduct a randomized study to compare the results obtained in patients that underwent a procedure of gastric drainage with those whose physiology and anatomy of the denervated pylorus are intact

  19. Análisis de la morbilidad y mortalidad en recién nacidos con peso inferior a 1500 g Analysis of morbidity and mortality in newborns weighing less than 1500 g

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    Yanett Sarmiento Portal


    in Pinar del Río Province. METHODS: An analytical, prospective, longitudinal and observational research in Neonatal Intensive Care Unit (NICU of this hospital between January and December, 2007. Group included all live neonates weighing less than 1500 g admitted in NICU during the established period and sample included 52 neonates. Variables like sex, gestational age, weight, and intrauterine growth, the need of mechanic ventilation, complications and survival were analyzed. In SPSS 12 was created a database. Variables were analyzed by conceptual method. RESULTS: There was predominance of male sex (53,9%, gestational ages was between 27 and 29,6 weeks (44,2% and uterine growth with a suitable weight according gestational age (84,6%. Hyaline membrane disease (55,8% and metabolic disorders (50% are the more frequent morbidities. The 59,6% of newborns needed mechanic ventilation and bronchopneumonia was the leading cause of death in 40% of cases. Survival rate was of 90,4%.

  20. [Detection and clinical analysis of acute lower respiratory tract infection with human coronaviruses in children in Beijing area 2007-2015]. (United States)

    Qian, Yi; Xie, Zhengde; Ren, Lili; Liu, Chunyan; Xiao, Yan; Xu, Baoping; Yang, Yan; Qian, Suyun; Geng, Rong; Shen, Kunling


    To investigate human coronaviruses (HCoVs) infection in children with acute lower respiratory tract infection(ALRTI)and to explore the clinical features of ALRTI caused by HCoVs in children. Totally 4 371 children with clinical diagnosis of ALRTI during the period from March 2007 to February 2015 seen in Beijing Children's Hospital were recruited into this study. Patients were divided into 4 groups by age, including 1 890 cases in respiratory viruses including HCoVs (including HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1), respiratory syncytial virus (RSV) and so on. Clinical features of ALRTI with single HCoVs infection were analyzed and compared with hospitalized ALRTI cases with single RSV infection in the same period. (1) Totally 2 895 cases were positive for at least one virus in this study in 4 371 ALRTI patients (positive rate 66.23%), in which 147 cases were positive for HCoVs infection (positive rate 3.36%). (2) Positive rates of HCoVs in each year from 2007 to 2014 were 6.11%, 3.79%, 4.69%, 4.31%, 2.38% 2.10%, 0.77% and 2.65%, respectively. The mean positive rates of HCoVs for each month from January to December were 2.53%, 2.12%, 3.63%, 6.68%, 1.53%, 3.77%, 3.92%, 3.00%, 2.15%, 5.26%, 3.01% and 2.80%. (3) Detection results of each subtypes of HCoVs in total 4 371 pediatric ALRTI patients were: 48 cases positive for HCoV-OC43(1.10%), 32 cases positive for HCoV-229E(0.73%), 25 cases positive for HCoV-NL63 (0.57%), 27 cases positive for HCoV-HKU1 (0.62%). (4) Positive rates of HCoVs infection in infection of HCoVs in this study, of which 12 cases were diagnosed as bronchopneumonia, 3 cases developed acute laryngeal obstruction, 2 cases had acute bronchial asthma attack. Common clinical manifestations included cough (14 cases), gasping (13 cases), dyspnea (9 cases), fever (6 cases), hoarseness (4 cases), laryngeal stridor (4 cases) and abnormality on chest X-ray (including fuzzy lung texture, patchy shadow and consolidation) (12 cases). (6) There were no

  1. Penetrating abdomino-thoracic injuries: report of four impressive, spectacular and representative cases as well as their challenging surgical management. (United States)

    Eder, Frank; Meyer, Frank; Huth, Christof; Halloul, Zuhir; Lippert, Hans


    towels, removed after 2 days), suture of the diaphragm, and pleural drainage. 4. A man was stabbed in the left thorax, resulting in pneumothorax and lesions of the diaphragm and left third of the transversal colon, and the neck, resulting in lesions of the pharynx and internal jugular vein. These injuries were approached with left thoracic drainage and suture of the colon and diaphragm lesions. Subsequent right thoracotomy was required to treat right pleural empyema caused by bronchopneumonia as a consequence of blunt thoracic trauma. In addition, the patient required relaparotomy to drain an abscess within the Douglas space and Billroth II gastric resection to control recurrent Forrest-Ia bleeding. Penetrating abdomino-thoracic injuries demand immediate life-saving measures, transfer to a trauma centre, appropriate resuscitative care, prompt diagnosis, and surgical intervention by an interdisciplinary team of abdominal, vascular, and cardiac surgeons. If these measures are provided, outcomes are maximized, mortality is minimized, and permanent damage can be avoided.

  2. Niveles de inmunoglobulinas IgA e IgM en recién nacidos y correlación con infección congénita

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    Rafael Ferrer Montoya


    Full Text Available Se realizó un estudio analítico y prospectivo en 600 recién nacidos, de los niveles sanguíneos de IgM e IgA y su relación con el riesgo de infección congénita. Se encontró elevada la IgM en 10 neonatos (1,7 % y la IgA en 18 (3 %. Se halló una buena correlación (OR y significancia estadística de IgM e IgA elevadas en los neonatos cuyas madres tuvieron líquido amniótico caliente y/o fétido, ruptura de las membranas de más de 24 horas y fiebre intraparto. También hubo una buena correlación (OR y significancia estadística de las Igs elevadas en neonatos con bronconeumonía y sepsis generalizada congénita. De los cultivos bacteriológicos existió una buena correlación (OR y significancia estadística en el hemocultivo y exudado faríngeo y las Igs elevadas y el residuo gástrico con la IgM elevada. Las bacterias grampositivas y gramnegativas aisladas en los neonatos tuvieron buena correlación (OR y significancia estadística, excepto para la IgA en las bacterias gramnegativas. Los 4 neonatos fallecidos por infección congénita tuvieron IgM elevadas.A prospective analytical study of IgM and IgA inmunoglobulin levels of 600 neonates and their correlation with congenital infection risks was made. 10 neonates (1.7 % presented a high IgM level whereas 18 (3 % had a raised IgA level. A good correlation (OR and statistical significance of raised IgA and IgM levels were found in newborns of mothers who had had hot and/or fetid amniotic fluid; ruptured membranes for over 24 hours and intralabor fever. Good correlation and statistical significance of high Igs were also present in neonates affected by bronchopneumonia and general congenital sepsis. As to the bacteriological cultures, good correlation and statistical significance was found in hemoculture and pharyngeal exudate, as well as raised Igs levels, and gastric residues with high IgM level. Gram-positive and gram-negative bacteria isolated from newborns presented good correlation

  3. Revascularização do miocárdio sem circulação extracorpórea em pacientes acima de 75 anos: análise dos resultados imediatos Myocardial revascularization without extracorporeal circulation in patients over 75 years of age: analysis of immediate results

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    Rodrigo Milani


    7.54±2.69%. The total number of distal anastomoses was 639. Seven (3.62% patients died, 3 due to bronchopneumonia, 1 due to mediastinitis, 1 due to metabolic causes, 1 due to cardiogenic shock, and another died suddenly after refixation of a sternal dehiscence. Reoperation due to bleeding, orotracheal reintubation, and prolonged mechanical ventilation were factors associated with an increase in mortality. CONCLUSION: The surgery adopted for myocardial revascularization was associated with a low mortality rate, a low complication index, and a short length of stay at the hospital.

  4. Intoxicação natural por Amaranthus spinosus (Amaranthaceae em ovinos no Sudeste do Brasil Amaranthus spinosus (Amaranthaceae poisoning in sheep in southern Brazil

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    Paulo Vargas Peixoto


    streaks extending from cortex to medulla, and congestion. Histologically there was a severe acute tubular nephrosis, dispersed foci of coagulative necrosis in the liver, areas of coagulative necrosis in the myocardium and acute incipient interstitial pneumonia as well as secondary bronchopneumonia. Myocardial coagulative necrosis observed in seven sheep was attributed to hyperkalemia secondary to renal insufficiency. No references to spontaneous A. spinosus poisoning in sheep was found in the literature. Attempt to reproduce the poisoning by administration of the plant to sheep was insuccessful, probably because A. spinosus used was not from fertilized areas.

  5. Multiple myeloma invasion of the central nervous system

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    Marjanović Slobodan


    Full Text Available Introduction. Multiple myeloma (MM is characterized by the presence of neoplastic proliferating plasma cells. The tumor is generally restricted to the bone marrow. The most common complications include renal insufficiency, hypercalcemia, anemia and reccurent infections. The spectrum of MM neurological complications is diverse, however, involvement of MM in the cerebrospinal fluid (CSF and leptomeningeal infiltration are rare considered. In about 1% of the cases, the disease affects the central nervous system (CNS and presents itself in the form of localized intraparenchymal lesions, solitary cerebral plasmocytoma or CNS myelomatosis (LMM. Case report. We presented the clinical course of a 55-year-old man with MM and LMM proven by malignant plasma cells in the CSF, hospitalized with the pain in the thoracic spine. His medical history was uneventful. There had been no evidence of mental or neurological impairment prior to the seizures. Physical examination showed no abnormalities. After a complete staging, the diagnosis of MM type biclonal gammopathia IgG lambda and free lambda light chains in the stage III was confirmed. The treatment started with systemic chemotherapy (with vincristine, doxorubicin plus high-dose dexamethasone - VAD protocol, radiotherapy and bisphosphonate. The patient developed weakness, nausea, febrility, dispnea, bilateral bronchopneumonia, acute renal insufficiency, confusions, headaches and soon thereafter sensomotor aphasias and right hemiparesis. The patient was treated with the adequate therapy including one hemodyalisis. His neurological status was deteriorated, so Multislice Computed Tomography (MSCT of the head was performed and the findings were normal. Analysis of CSF showed pleocytosis, 26 elements/ mL and increased concentrations of proteins. Cytological analysis revealed an increased number of plasma cells (29%. Electrophoretic analysis of proteins disclosed the existance of monoclonal components in the serum

  6. Doenças de ovinos diagnosticadas no Laboratório de Anatomia Patológica Animal da Universidade Federal de Mato Grosso do Sul (1996-2010 Sheep diseases diagnosed at the Laboratory of Animal Pathology, Federal University of Mato Grosso do Sul, Brazil (1996-2010

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    Thiago L. Almeida


    compile data and perform retrospective studies to provide important insight for professionals. A prevalence study from January 1996 to December 2010 was carried out in the archives of Laboratório de Anatomia Patológica Animal (LAP, Universidade Federal de Mato Grosso do Sul (UFMS. Laboratório de Bacteriologia, UFMS, and Setor de Patologia Veterinária at Universidade Federal do Rio Grande do Sul helped on the diagnostic of pulmonary mannheimiosis and scrapie respectively. The reports for sheep were reviewed and grouped into conclusive and inconclusive ones. The conclusive cases were classified according to the etiology of the disease. In the period, 331 exams (3.97% were done. Sixty-four experimental cases and materials from other states or countries (19.3% were excluded. Remaining cases (267, eighty-seven (32.6% were inconclusive and 180 (67.4% were considered conclusive reports, were classified according to the etiology: 60 (33.3% infectious and parasitary diseases; 45 (25% were poisonings and toxi-infections; 41 (22.8% were summarized as "injuries without apparent cause"; 22 (12.2% cases of metabolic and nutritional diseases; 10 (5.6% were classified as "other disorders" and 2 (1.1% case of neoplasms. Haemonchosis, fibrinonecrotic or fibrinopurulent pleuropneumonia, bronchopneumonia and pneumonia, poisonings by Brachiaria spp. and copper poisoning were the most prevalent diseases in sheep. Two cases of scrapie have been diagnosed in this period.

  7. Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis: the New EPOC randomised controlled trial. (United States)

    Primrose, John; Falk, Stephen; Finch-Jones, Meg; Valle, Juan; O'Reilly, Derek; Siriwardena, Ajith; Hornbuckle, Joanne; Peterson, Mark; Rees, Myrddin; Iveson, Tim; Hickish, Tamas; Butler, Rachel; Stanton, Louise; Dixon, Elizabeth; Little, Louisa; Bowers, Megan; Pugh, Siân; Garden, O James; Cunningham, David; Maughan, Tim; Bridgewater, John


    alone and 129 to chemotherapy with cetuximab between Feb 26, 2007, and Nov 1, 2012. 117 patients in the chemotherapy alone group and 119 in the chemotherapy plus cetuximab group were included in the primary analysis. The median follow-up was 21.1 months (95% CI 12.6-33.8) in the chemotherapy alone group and 19.8 months (12.2-28.7) in the chemotherapy plus cetuximab group. With an overall median follow-up of 20.7 months (95% CI 17.9-25.6) and 123 (58%) of 212 required events observed, progression-free survival was significantly shorter in the chemotherapy plus cetuximab group than in the chemotherapy alone group (14.1 months [95% CI 11.8-15.9] vs 20.5 months [95% CI 16.8-26.7], hazard ratio 1.48, 95% CI 1.04-2.12, p=0.030). The most common grade 3 or 4 adverse events were low neutrophil count (15 [11%] preoperatively in the chemotherapy alone group vs six [4%] in the chemotherapy plus cetuximab group; four [4%] vs eight [8%] postoperatively), embolic events (six [4%] vs eight [6%] preoperatively; two [2%] vs three [3%] postoperatively), peripheral neuropathy (six [4%] vs one [1%] preoperatively; two [2%] vs four [4%] postoperatively), nausea or vomiting (four [3%] vs six [4%] preoperatively; four [4%] vs two [2%] postoperatively), and skin rash (two [1%] vs 21 [15%] preoperatively; 0 vs eight [8%] postoperatively). There were three deaths in the chemotherapy plus cetuximab group (one interstitial lung disease and pulmonary embolism, one bronchopneumonia, and one pulmonary embolism) and one in the chemotherapy alone group (heart failure) that might have been treatment related. Addition of cetuximab to chemotherapy and surgery for operable colorectal liver metastases in KRAS exon 2 wild-type patients results in shorter progression-free survival. Translational investigations to explore the molecular basis for this unexpected interaction are needed but at present the use of cetuximab in this setting cannot be recommended. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Artritis séptica no gonocóccica en el Hospital Universitario San Vicente de Paúl (1984-1992 Non-Gonococcal septic arthritis at Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 1984-1992

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    Oscar Uribe


    class="MsoNormal">Non-gonococcal septic arthritis is a rheumatological emergency; early diagnosis and treatment prevent deformities and disabilities. A retrospective study of this disease was carried out for the period 1984-1992, at Hospital Universitario San Vicente de Paúl, Medellín, Colombia; 54 patients older than 12 years were found that presented clinical manifestations of septic arthritis and in whom etiologic diagnosis was established by either joint fluid or blood culture. The following aspects were Included in the survey: form of presentation, predisposing factors, etiology and complications. There were 38 males (70.4% and 16 females (29.6%; average age was 27 years. The disease was monoarticular In 49 cases (90.7% and affected 2 joints In 5; In decreasing order of frequency the following joints were Involved: knee (30 cases; 55.6%; hip (19 cases; 35.2%, ankle and shoulder (3 cases each, sacroiliac joint (2 cases, metacarpophalangic and sterno clavicular joints (1 case each. The infection was due to Staphylococcus aureus in 43 cases (79.6% followed by Gram-negative bacilli (9 cases; 16.7%; the remaining 2 cases were streptococcal. Complications were sepsis (13 cases, ostomyelitis (13 cases, bronchopneumonia (6 cases, renal insufficiency (3 cases, Intravascular disseminated coagulation (1 case and pericarditis (1 case; these 37 complicating events occurred In 23 patients. Predisposing factors and underlying diseases were as follows: soft tissue infection (9 , patients, endometritis (3 patients, systemic erythematous lupus (2 patients, non-Hodgkin Iymphoma (2 patients, rheumatoid arthritis and intra-articular Injection (1 patient each. Evolution had been longer than one week In 43 patients (79.6% when they first attended the Hospital; despite the delay there were no fatalities.

  9. Sorotipagem de amostras de Streptococcus suis isoladas de suínos em granjas dos Estados de São Paulo, Minas Gerais e Paraná Serotyping of Streptococcus suis strains isolated from pigs in the States of São Paulo, Minas Gerais e Paraná, Brazil

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    Keila J.R. Pagnani


    -aglutinação, para a sorotipagem das amostras de S. suis. A sorotipagem das 51 amostras isoladas mostraram os seguintes resultados: 30 (58,8% foram classificadas como sorotipo 2, 11 (21,6% das amostras como sorotipo 3, sete (13,72% como sorotipo 7, duas (3,92% como sorotipo 1 e uma amostra como pertencente ao sorotipo14 (1,96%. Este é o primeiro relato do isolamento de um grande número de amostras de S. suis no Brasil, de casos típicos de processos infecciosos causados por esta bactéria. Também foi realizada a sorotipagem dos isolados, mostrando uma alta prevalência do sorotipo 2, quando comparada com a dos demais sorotipos encontrados.Streptococcus suis infection in swine is common in all countries where hog production is well developed. This infection has been associated with bronchopneumonia, meningitis, arthritis, pericarditis, myocarditis, endocarditis, fibrinous polyserositis, septicaemia, rhinitis, and abortion. Streptococcus suis has also been described as a pathogen for ruminants and humans. In Brazil there are several clinical evidences about the existence of S. suis disease in pigs affecting more than 50% of farms in States of São Paulo, Minas Gerais and Paraná. In the present research 51 strains of S. suis isolated from piggeries of the States of São Paulo, Minas Gerais and Paraná were collected from different pathologies such as septicaemia, meningitis, arthritis and pneumonia and been recovered either in pure culture or as the predominant organism from porcine tissues. Culture of specimens was carried out on 5% bovine blood agar plates incubated at 37°C for 24 hr. For the biochemical identification the a-hemolytic colonies of all capsulated isolates were submitted to various conventional tests, such as hydrolysis of arginine, Voges-Proskauer Test, and production of acid from various carbohydrates (inulin, salicin, trehalose, lactose, sucrose, sorbitol, mannitol and glycerol. The strains were also tested for their ability to grow in the presence of 6,5% Na

  10. Implante transapical de endoprótese valvada balão-expansível em posição aórtica sem circulação extracorpórea Off-pump transapical balloon-expandable aortic valve endoprosthesis implantation

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    Diego Felipe Gaia


    ão.OBJECTIVE: The aortic valve replacement is a routine procedure, and involves replacement of the native valve/prosthesis. In most of the patients who undergo such procedure the risk is acceptable, but in some cases, such risk can justify contraindication. The minimally invasive transcatheter aortic valve implantation without cardiopulmonary bypass (CPB has been shown to be viable, with lower morbidity and mortality. The aim of this study was to develop a catheter-mounted aortic bioprosthesis for implantation without CPB. METHODS: After developing in animals, three patients with high EuroSCORE underwent implantation. Case 1: patients with bioprosthesis dysfunction; Case 2: severe aortic stenosis; Case 3: dysfunction of aortic bioprosthesis. After minithoracotomy and under echocardiographic and fluoroscopic control, a balloon catheter was placed on aortic position and inflated. After, a second balloon with valved endoprosthesis was positioned and released under high ventricular rate. Echocardiographic and angiographic controls were performed and the patients were referred to ICU. RESULTS: In the first case, implantation without CPB was possible with appropriate results. The patient evolved with improvement of ventricular function. After, this patient developed bronchopneumonia, tracheoesophageal fistula and died due to mediastinitis. Autopsy confirmed proper valve positioning and leaflets preservation. The second case showed the device migration after inflation of the balloon, with the need for urgent median sternotomy, CPB and conventional valve replacement. This patient evolved well and was discharged from the ICU on the 14th postoperative day without complications. This patient developed respiratory infection, septic shock and died on the 60th postoperative day. The patient from the third case underwent successful implantation. CONCLUSION: The off-pump transapical implantation of catheter-mounted bioprosthesis was shown to be a feasible procedure. Technical details and learning

  11. C3. Pneumonias da comunidade num serviço de Pneumologia

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    Sandra André


    , sendo a ausência de resposta clínica o motivo mais frequente (6.As principais complicações foram: derrame pleural parapneumónico -4; Empiema -1; Pneumotórax -1; Pneumonia necrotizante -4.A baixa rentabilidade diagnóstica pode dever-se à realização de exames microbiológicos após início de antibioterapia. A duração do internamento parece estar relacionada com o tempo de antibioterapia e com a presença de complicações. O padrão radiológico não se correlaciona com o tempo de internamento. : Community-acquired pneumonia (CAP is a frequent cause of hospital admission and its characterization is important to standardize medical procedures.The aim of this study was to evaluate the clinical, laboratorial and radiological presentation features of CAP, its microbiological diagnosis, management, clinical evolution and major complications.We aimed to studied prospectively patients admitted in our Pneumology Department between 2002 June and 2003 May with CAP diagnosis, using a special designed protocol. 23 patients (15 men and 8 women were admitted. 43,5% were active smokers.Average stay length was 14,0±8,0 days. 43,5% of patients had associated pathology.Evolution of symptoms before admission was 5,4±2,8 days. Sputum production, thoracic pain, dyspnoea and fever were the most often presentation symptoms. 73,4% of patients was hypoxemic. The most sensitive laboratorial data were elevated white blood count, SR or PCR.About radiological presentation: bilateral involvement -9; unilateral d”1 lobe – 12, > lobe –2; pleural effusion associated -6; cavitation -4; atelectasis -1. Bronchopneumonia pattern was the most prevalent (56,5%.Microbiological diagnosis was attempted in 39%.Empirical antibiotic regimen was started in all patients. First choice antibiotics were: cephalosporin+macrolide – 6; amoxycillin/ clavulanate -3; levofloxacin -2; macrolide -3; other regiments with macrolide -4. Patients with

  12. Síndrome antissintetase anti-Jo-1 Anti-Jo-1 antisynthetase syndrome

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    Samuel Katsuyuki Shinjo


    . Clinical-laboratory and demographic data were obtained from medical files. All patients fulfilled the Bohan and Peter criteria (1975 and presented anti-Jo-1, articular, muscle and lung involvement. Eighteen patients with anti-Jo-1 ASS were analyzed. RESULTS: The mean age at disease onset was 39.9 ± 15.7 years and average disease duration was 9.7 ± 7.0 years. All subjects were white, and 94.4% were female. Constitutional symptoms occurred in 50 % of cases. There was cutaneous and gastrointestinal tract involvement in 66.6% and 55.6% of cases, respectively. No cases manifested neurologic or cardiac involvement. Half of the patients showed incipient pneumopathy, ground-glass opacities and basal pulmonary fibrosis. There was one case of tuberculosis, three of herpes zoster and one of non-Hodgkin lymphoma. One death occurred due to sepsis shock (hospital bronchopneumonia. All patients received prednisone (1mg/kg/day and 12 (66.7% participants received methyl prednisolone pulse therapy (1g/day, 3 days. Various immunosuppressants were used as corticosteroid tapers, depending on tolerance, side effects and/or refractoriness. Although disease relapse (clinical and/or laboratory occurred in 87.5% of cases, 12 out of 16 patients (75% were in disease remission at study endpoint. CONCLUSION: In the present study, almost all patients were white females and the disease relapse rate was high.

  13. Perfil de internações hospitalares por doenças respiratórias em crianças e adolescentes da cidade de São Paulo, 2000-2004 Perfil de internaciones hospitalares por enfermedades respiratorias en niños y adolescentes de la ciudad de São Paulo, 2000-2004 Hospital admissions due to respiratory diseases in children and adolescents of São Paulo city, 2000-2004

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    Renata Martins de T Natali


    described. RESULTS: Pneumonia and bronchopneumonia (51%, asthma (18% and acute and chronical diseases from upper airways (10% accounted for most of the admissions. Children up to five years are most frequently hospitalized, regardless of the specific cause. Among adolescents, the main causes of hospitalization were respiratory diseases that affects mainly the interstitial lung (0.1% and the necrotic and suppurative diseases of lower airways (0.2%. From the age of six to ten years, admissions for acute and chronic diseases from upper airways (10% were predominant. The peak of morbidity occurs in early autumn. There was a trend towards increasing hospital admissions for respiratory illnesses during the analyzed period. CONCLUSIONS: The distribution of hospital admissions for respiratory diseases in children and adolescents is dependent on age and season. The younger the age the greater the number of hospital admissions.

  14. Clonidina como droga adjuvante no tratamento da síndrome de abstinência alcoólica em unidade de terapia intensiva: relato de caso Clonidina como droga coadyuvante en el tratamiento de la síndrome de abstinencia alcohólica en unidad de terapia intensiva: relato de un caso Clonidine as adjuvant therapy for alcohol withdrawal syndrome in intensive care unit: case report

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    Leandro Gobbo Braz


    alta de la UTI. CONCLUSIONES: La droga escogida para el tratamiento del síndrome de abstinencia alcohólico es el benzodiazepínico. No obstante, en el presente relato, solamente el uso coadyuvante de clonidina consiguió proporcionar tratamiento adecuado al paciente.BACKGROUND AND OBJECTIVES: Sedation of patients with past history of alcohol and drug abuse in Intensive Care Units (ICU is a challenge due to the high incidence of sedative drugs tolerance and withdrawal syndromes. This report aimed at describing a case of a young patient admitted to the ICU who developed alcohol withdrawal syndrome and tolerance to sedatives, resolved only after clonidine administration. CASE REPORT: Male patient, 18 years old, alcohol, tobacco, cocaine and marijuana abuser, victim of firearm accident, who was admitted to the ICU in the first post-enterectomy day, after gastric content aspiration during tracheal re-intubation. Clinical evolution was: vasoactive drugs up to the 4th day; bilateral bronchopneumonia with pleural effusion and need for artificial ventilation up to the 15th day. Initial sedation scheme was the association of midazolam and fentanyl. As from the 4th day, patient presented with several psychomotor agitation episodes, even after the association of lorazepam in the 6th day. In the 9th day, patient received the largest doses but remained agitated. Dexmedetomidine was associated, which has decreased other drug doses in 35% and has improved agitation. In the 12th day, midazolam and dexmedetomidine were replaced by propofol infusion with worsening of agitation. In the 13th day, clonidine was associated to the sedation scheme with total resolution of agitation. Propofol was withdrawn in the 14th day, fentanyl was maintained and midazolam infusion was restarted, with doses 75% and 65% lower as compared to peak doses of such drugs. Patient was extubated in the 15th day and was discharged from ICU. CONCLUSIONS: Benzodiazepines should remain the drugs of choice for the